SAN FRANCISCO—Radiotherapy following chemotherapy does not improve survival in patients with stage III/IV Hodgkin’s lymphoma (HL) who have a complete response to chemotherapy. It does, however, improve survival in partial responders, according to results from the phase III EORTC (European Organization for Research and Treatment of Cancer) trial 20884. The findings were presented at the 43rd Annual Meeting of the American Society for Therapeutic Radiology and Oncology (plenary 3).
"For patients with stage III or IV Hodgkin’s lymphoma who have been treated with MOPP/ABV and reached complete remission, involved-field radiotherapy does not improve outcome," said Berthe Aleman, MD, of the Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam. "If, however, they reach partial remission, involved-field radiotherapy results in the same excellent recurrence-free survival, event-free survival, and overall survival as patients who have reached complete remission."
Between November 1989 and April 2000, the EORTC Lymphoma Group enrolled 736 patients with stage III/IV Hodgkin’s lymphoma into the study. All patients were initially treated with four courses of MOPP/ABV chemotherapy.
Complete response to initial chemotherapy was defined as the complete disappearance of all measurable lesions and disease-related symptoms; 60% of the patients achieved complete remission and 35% achieved partial remission after initial chemotherapy.
Patients in complete remission after initial chemotherapy received another two courses of MOPP/ABV, for a total of six courses, and were then randomized to the control arm (no further treatment) or the experimental arm (involved-field radiotherapy).
Patients in partial remission after initial chemotherapy also received two more courses of standard chemotherapy and were then evaluated for remission status. If they were then in complete remission, they received yet another two courses of MOPP/ABV, for a total of eight courses, and were then randomized to the control or experimental arm.
All patients who were still in partial remission after six courses of MOPP/ABV were treated with radiotherapy to all initially involved organs and lymph node areas. Patients who failed at any time during the investigation went off study.
