Two Cycles of MOPP and Definitive Radiotherapy for Stage IIIA and IIIB Hodgkin’s Disease

Abstract

Combination chemotherapy is generally viewed as the treatment of choice for stage IIIB Hodgkin’s disease (DeVita et al. 1980). However, trials that have employed adjuvant radiotherapy (XRT) have claimed better results (Horning et al. 1984; Prosnitz et al. 1982). Some of this improvement may be due to a lower incidence in nodal relapse, the primary pattern of recurrence in patients treated with chemotherapy only (Young et al. 1978; DeVita 1976). In the past, definitive XRT was advocated for stage IIIA (Rosenberg and Kaplan 1975). Recent studies have demonstrated that multiple-agent chemotherapy alone or in combination with XRT gives better disease-free survival rates than XRT alone for most patients with stage IIIA (Mauch et al. 1985; Kun et al. 1976; Lister et al. 1983; Bonadonna et al. 1979; Crowther et al. 1984). Most combined modality treatment programs have required a minimum of six cycles of chemotherapy, and the sequencing of radiotherapy has dependend on the individual programs. Despite the overall improvements in results that have been achieved with combined modality treatment, prognostic factors, other than constitutional symptoms and extent of abdominal disease, have not been well delineated (Carbone et al. 1971; Desser et al. 1977; Mazza et al. 1984; Stein et al. 1982; Hoppe et al. 1982).