2009•OnkologieRequires access
Therapie der Hodgkin-Lymphome
Michael Pfreundschuh, Markus Löffler, U Rühl, Erhard Hiller, H Gerhartz, W. Wilmanns, Hartmut H. Kirchner, W. D. Schoppe, Sabine Petsch, H. Bartels, Karl-Heinz Pflüger, Johannes V. Teichmann, Roland J. Fuchs, G. Kühn, W. Oertel, Roland Mertelsmann, Gottfried Dölken, K.P. Schalk, Peter K. M. Worst, M. Wilhelmy, Winfried Gassmann, U. Loos, R. Hinterberger, H. Theml, T. Wagner, S. Samandari, W. Schäfgen, J. Preiss, Norbert Schmitz, W. Mende, B. Mödder, H.J. Schick, Volker Diehl
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Abstract
Between July 1983 and May 1987 143 untreated patients with Hodgkin's lymphoma in stages I-IIIA with risk factors qualified for the HD1 protocol, and 230 patients in stages IIIB/IV qualified for HD3. Patients in HD1 received a combined chemo-radiotherapy (2 x COPP + ABVD + 20 Gy EF vs. 40 Gy EF). Patients in HD3 received induction chemotherapy (3 x COPP + ABVD) and were randomized into consolidation by radiotherapy (20 Gy IF) vs. chemotherapy (1 x COPP + ABVD). In HD1, 73 of 89 evaluable patients (82%) achieved a complete remission. The survival of patients in stages I-IIIA with risk factors treated according to HD1 is as good as the survival of patients in stages I and II without risk factors. In HD3, 86 of 137 patients (63%) achieved complete remission after induction chemotherapy with 3 x COPP + ABVD. This is significantly better than the 31% complete remission rate observed in a pilot study with COPP alone (p less than 0.01). Including salvage therapy (radiotherapy in case of persisting nodal disease; chemotherapy with 4 x CEVD in case of persisting disseminated disease), a total of 76% complete remissions in stages IIIB/IVAB were achieved. An ESR greater than 80 mm/h was the most significant single risk factor in stages IIIB/IV for induction of CR and freedom from progression.