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| |  DG DISPATCH - ASTRO: Method Of Treatment Affects Hodgkin’s Disease Progression By Maria Bishop Special to DG News
BOSTON, MA -- October 27, 2000 -- For patients with stage II Hodgkin’s disease, the method of treatment has a significant effect on future freedom from progression. Researchers at the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Boston, MA from the University of Texas M.D. Anderson Cancer Center in Houston, TX, presented the results of their study involving 642 patients with stage II Hodgkin’s disease treated at their centre. The study was chaired by Zhongxing X. Liao, MD, assistant professor of the radiation oncology department. Patients in this study had been treated with radiation alone (n = 258), chemotherapy (n = 29), and combination radiotherapy and chemotherapy (n = 355). All patients had been treated at the center between June 1967 and December 1997, comprising 30 years of experience in the treatment of this disease. In all patients, a bone-marrow biopsy and aspiration had been performed, and other diagnostic tests. Most patients (n = 524) were diagnosed with nodular sclerosis or mixed cellularity (n = 82). Radiation-therapy techniques in this long-term study included mostly involved or regional field (n= 92), extended field (n = 230) and subtotal nodal irradiation (n = 122). Chemotherapy was mostly MOPP (a combination of mustine, vincristine [Oncovin] and procarbazine with the corticosteroid prednisolone) (n = 142) and NOVP (mitoxantrone [Novantrone], vincristine [Oncovin], vinblastine and prednisone) (n = 141). For the 493 surviving patients, there was a median follow-up of nine years; 168 patients developed disease progression. The most frequent site of disease progression was infield, followed by trans-diaphragm, visceral, adjacent area and others; rates of future freedom from progression (FFP) were 73 percent, 71 percent and 69 percent, respectively. The median survival time for the whole group was nearly 26 years, with 10-, 20- and 30-year survival rates of 83 percent, 65 percent and 36 percent, respectively. The corresponding rates of FFP were 73 percent, 71 percent and 69 percent. Treatment modalities, noted the researchers, did not affect the rate of overall survival. They did, however, have a significant impact on FFP rates. Ten- and 20-year FFP rates were 82 percent and 79 percent for patients who were treated with a combination of radiotherapy and chemotherapy. These rates are in contrast with 63 percent and 61 percent for patients who were treated with radiation therapy alone, and 62 percent and 62 percent for patients treated with chemotherapy alone. Researchers noted that an analysis of disease-progression and late-complications of therapy patterns is currently underway.
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