Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA nonbulky Hodgkin disease Journal Article


Authors: Straus, D. J.; Portlock, C. S.; Qin, J.; Myers, J.; Zelenetz, A. D.; Moskowitz, C.; Noy, A.; Goy, A.; Yahalom, J.
Article Title: Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA nonbulky Hodgkin disease
Abstract: To determine whether combined modality therapy (CMT) is superior to chemotherapy (CT) alone, 152 untreated Hodgkin disease patients with clinical stages (CSs) IA, IB, IIA, IIB, and IIIA without bulk disease were prospectively randomized to 6 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) alone or 6 cycles of ABVD followed by radiation therapy (RT) (3600 cGy: involved field for 11 patients, modified extended field for the rest). Of 76 patients randomized to receive RT, 65 actually received it, and 11 did not (4 progressed, 1 had bleomycin toxicity, 6 refused). For ABVD + RT, the complete remission (CR) percentage was 94% and no major response, 6%. For ABVD alone, 94% achieved a CR; 1.5%, a partial response (PR); and 4.5%, no major response. At 60 months CR duration, freedom from progression (FFP), and overall survival (OS) for ABVD + RT versus ABVD alone are 91% versus 87% (P = .61), 86% versus 81% (P = .61), and 97% versus 90% (P = .08), respectively (log-rank). The 95% confidence intervals for CR duration, FFP, and OS differences at 5 years were -8% to 15%, -8% to 18%, and -4% to 12%, respectively. Although significant differences were not seen, it is possible that a benefit in outcome of less than 20% for CMT might be seen in a larger trial. © 2004 by The American Society of Hematology.
Keywords: adolescent; adult; cancer survival; controlled study; treatment outcome; aged; middle aged; survival analysis; major clinical study; clinical trial; neutropenia; doxorubicin; cancer combination chemotherapy; cancer growth; side effect; cancer radiotherapy; combined modality therapy; radiotherapy, adjuvant; cancer staging; neoplasm staging; prospective study; dacarbazine; melanoma; controlled clinical trial; lung toxicity; basal cell carcinoma; blood toxicity; leukopenia; nausea; randomized controlled trial; thrombocytopenia; antineoplastic combined chemotherapy protocols; skin cancer; vinblastine; hodgkin disease; fever; chemotherapy induced emesis; cancer regression; remission induction; bleomycin; stomach carcinoma; lung diseases; humans; human; male; female; priority journal; article
Journal Title: Blood
Volume: 104
Issue: 12
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2004-12-01
Start Page: 3483
End Page: 3489
Language: English
DOI: 10.1182/blood-2004-04-1311
PROVIDER: scopus
PUBMED: 15315964
DOI/URL:
Notes: Blood -- Cited By (since 1996):130 -- Export Date: 16 June 2014 -- CODEN: BLOOA -- Source: Scopus
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MSK Authors
  1. Joachim Yahalom
    625 Yahalom
  2. Carol Portlock
    204 Portlock
  3. Craig Moskowitz
    407 Moskowitz
  4. Ariela Noy
    351 Noy
  5. Jing Qin
    86 Qin
  6. Andrew D Zelenetz
    767 Zelenetz
  7. David J Straus
    356 Straus
  8. Andre Goy
    30 Goy
  9. Jane E Myers
    17 Myers