The Chemotherapeutic Treatment of Advanced Hodgkin's Disease
R. Epelbaum1, N. Haim1, M. Ben-Shahar1, I. Valtuch1, D. Faraggi3, A. Sharabi-Nov3, Y. Ben-Arie2, Y. Cohen4
Departments of Oncology1 and 2Pathology, Rambam Medical Center, and Faculty of Medicine, Technion-Israel Institute of Technology; 3Department of Statistics, Haifa University, Haifa; and 4Department of Oncology, Soroka University Medical Center, Beer Sheba
Between 1972 and 1994, 121 adult patients with advanced Hodgkin's disease received MOPP (M) combination chemotherapy, MOPP alternating with ABVD (M-A) or MOPP and ABV hybrid (M/A). Radiation therapy was given to 1/3 of them. The median age was 35 years, 58% had stage III and 42% had stage IV disease. Failure-free survival at 10 years was 43.9%. It was 66.7%, 48.4% and 29.9% for patients treated by M/A, M-A and M, respectively. Overall survival at 10 years was 40.8%, and 78.2%, 48% and 27.7% for patients treated by M/A, M-A and M, respectively. Multivariate analysis found age (above or below 65 years) and combination chemotherapy (with or without adriamycin) to be significant prognostic factors. M/A combination was more myelotoxic, while M combination caused more second primaries. Today, 80% of patients with advanced Hodgkin's disease may be cured, with low rate of long-term toxicity.