EBVD combination chemotherapy plus low dose involved field radiation is a highly effective treatment modality for early stage Hodgkin's disease

To evaluate the efficacy of EBVD combination chemotherapy followed by low d ose (LD) involved field (LF) radiation therapy (RT) in patients with clinic al stage (CS) I-IIA Hodgkin's disease (HD), we analyzed 148 patients treate d in our Unit from March 1988 to November 1995, EBVD consisted of Epirubici ne 40mg/m(2), Bleomycin 10mg/m(2), Vinblastine 6mg/m(2) and Dacarbazine 300 mg. All drugs were administered i.v, at days 1 and 15, every 4 weeks, for a total of 4-6 cycles. LDIF RT (24-32Gy) was scheduled for patients with com plete response (CR) or >90% reduction of tumor load, after EBVD. Patients w ith stable or progressive disease (SD, PD) after EBVDx3 or poor compliance to the regimen received mantle or inverted Y RT at standard dose. The media n follow-up of patients currently alive was 71.5 months. 129 patients achie ved a CR after EBVD and 10 a >90% reduction of tumor load, for a post-CT re sponse rate of 94%. Eight patients had SD after EBVDx3 and one had a partia l response with poor compliance. All 9 patients received mantle or inverted Y RT and 8/9 achieved a CR. Nine patients relapsed at a median of 7 months from the end of treatment. At 10 years, FFS was 90% and overall survival 9 5%. Six patients have died so far; 5 of HD and one of stroke. One patient d eveloped a diffuse large cell lymphoma 48 months after the diagnosis of HD, We conclude that EBVD followed by LDIF RT is a highly effective regimen fo r patients with CS I-IIA HD, Longer follow up is required to assess the ris k of secondary malignancies, especially solid tumors.