NEW YORK (Reuters Health) – A report in the February 1st issue of the Journal of Clinical Oncology confirms preliminary findings that Stanford V chemotherapy plus radiation to bulky disease sites is effective in treating advanced Hodgkin's disease.
Dr. Sandra J. Horning and colleagues, from the Stanford University Medical Center, California, studied the outcomes of 142 patients with stage III or IV or locally extensive mediastinal stage I or II Hodgkin's disease.
These patients received 12 weeks of Stanford V chemotherapy followed by 36-Gy radiotherapy to "sites of bulky (5 cm or greater) or macroscopic splenic disease."
After a median follow-up of 5.4 years, lack of disease progression was seen in 89% of patients and overall survival was 96%. There were no treatment-related deaths and none of the patients experienced disease progression during therapy, the researchers report.
For patients who had prognostic scores of 0 to 2, freedom from disease progression was significantly greater (94%) compared with patients with prognostic scores of 3 or more (75%, p < 0.0001), Dr. Horning's team notes.
No cases of secondary leukemia were diagnosed. "Among 16 patients who relapsed, the freedom from a second relapse was 69% at 5 years," they write. The investigators also found that since treatment there have been 42 pregnancies to date.
"We believe the present data with Stanford V and radiation therapy are highly encouraging and deserving of additional study in the present E2496 intergroup trial comparing this approach to doxorubicin, bleomycin, vinblastine and dacarbazine," Dr. Horning and colleagues conclude.
"Because cure is possible for all patients with Hodgkin's disease, it is increasingly important to define optimal treatment in the context of cure rate and early and late toxicity," they add.
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