A RANDOMIZED STUDY COMPARING CHEMOTHERAPY ALONE WITH CHEMOTHERAPY FOLLOWED BY RADIOTHERAPY IN PATIENTS WITH PATHOLOGICALLY STAGED-IIIA HODGKINS-DISEASE

The 5-yr follow-up (range, 1-8 yr) of 56 patients with pathologic stage IIIA Hodgkin''s disease randomized for chemotherapy alone or chemotherapy followed by radiotherapy to previous areas of disease (26 treated with mustine, vinblastine, procarbazine and prednisolone [MVPP] alone; 30 with MVPP and radiotherapy) is reported. Of the 56 patients, 53 (95%) achieved a complete remission with chemotherapy. Of these, only 5 (9%) have relapsed; 3 died of Hodgkin''s disease. There was no improvement in relapse-free survival associated with the uses of radiotherapy following chemotherapy, but in view of the same numbers of relapses and the excellent results following chemotherapy alone, a significant improvement could not be expected. The use of MVPP alone can be recommended as an alternative therapy for patients with stage IIA Hodgkin''s disease. This avoids both the physical and psychologic morbidity associated with the high relapse rate following extensive primary radiotherapy and the necessity of combined modality treatment for .apprx. 1/2 these patients. The question of whether radiotherapy should be given to areas of previous bulk following chemotherapy has not yet been answered in this trial which is continuing.