Klin Onkol 2000; 13(2): 52-57.
b>Summary: Background: The results of treatment of advanced stages of Hodgkin’s disease have been unsatisfactory up to now. Following the present standard therapy COPP/ABVD ± radiotherapy, only 50 - 60 % patients survive for 5 to 10 years. Design and subjects: Many retrospective analyses have shown the intensity of the dose to be correlated with the outcome of the therapy. This is being tested by the German Hodgkin’s Lymphoma Study Group (GHSG) in a large randomized trial HD9 which compares the BEACOPP regimen (basal form - arm B, and escalated form - arm C) with the standard chemotherapy COPP/ABVD - arm A.
Methods and Results: HD9 interim analysis 02/99: 1070 patients were subjected to evaluation (A= 262, B = 405, C = 403). Complete remission (CR) after the end of therapy: arm C 96 %, arm B 88 %, arm A 83 %. Progressive disease up to 3 months after therapy: C 2%, B 8%, A 12 % (p < 0.05). FFTF (Freedom from Treatment Failure) reveals significantly better results C > A, C > B and B > A. Under a 28-month median observation time, no significative difference has been found in the SV (survival) values B = C, but signif. C > A and B > A.
Our own results: 1995 - 1998, 35 patients FNKV Prague underwent treatment according to protocol HD9 (20 randomized). Arm A - 5 patients (2 died , one patient due to another ailment, one patient due to progression). Arm B - 11 patients (3 underwent progression, 2 died). Arm C - 19 patients (one patient died of generalised histiocytosis). Median observation time is 23 months. Conclusions: The escalated BEACOPP regimen reveals better FFTF values as compared with the basal form and COPP/ABVD (a result of the decreased percentance of progressive disease and early relapse). Acute toxicity is considerable, but manageable. The BEACOPP regimen reduces the importance of prognostic factors.
