Rueda Domínguez A, Márquez A, Gumá J, Llanos M, Herrero J, de Las Nieves M A, Miramón J, Alba E
Servicio de Oncología, Hospital Clínico Universitario, Málaga, Spain.
Ann Oncol. 2004 Dec;15(12):1798-804. doi: 10.1093/annonc/mdh465.
Chemotherapy with ABVD (doxorubicin, bleomycin, vinblastine and darcarbacine) schedule is the standard treatment for advanced Hodgkin's lymphoma. Certain facts, including a low toxicity compared with MOPP/ABV (mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin and vinblastine) and minimal potential for inducing second neoplasias or patient sterility, support the use of ABVD to treat early disease stages. In the present study, we prospectively evaluated the long-term efficacy and toxicity of six cycles of ABVD as treatment for early-stage Hodgkin's lymphoma.
From January 1990 to June 2002, 95 patients with stage I and II Hodgkin's lymphoma were treated with six ABVD cycles. Fifteen patients who met the criteria for mediastinal bulky disease also received further radiotherapy on the mediastinum.
After six cycles, 89 patients (94%) showed a complete response (CR) and six patients (6%) showed a partial response (PR). These PRs became CRs after radiotherapy. After a median follow-up of 78 months, 14 patients had relapsed and three had died. Overall survival and progression-free survival rates at 7 years were 96% and 84%, respectively. For patients with stage IA and IIA without mediastinal bulky disease, the survival rates were 97% and 88%, respectively.
The administration of six ABVD cycles is an effective and safe treatment in patients with stage I and II Hodgkin's lymphoma.
采用ABVD(多柔比星、博来霉素、长春碱和达卡巴嗪)方案进行化疗是晚期霍奇金淋巴瘤的标准治疗方法。与MOPP/ABV(氮芥、长春新碱、丙卡巴肼、泼尼松、多柔比星、博来霉素和长春碱)相比,ABVD毒性较低,诱导第二肿瘤或导致患者不育的可能性极小,这些因素支持将ABVD用于治疗疾病早期阶段。在本研究中,我们前瞻性评估了六个周期的ABVD治疗早期霍奇金淋巴瘤的长期疗效和毒性。
1990年1月至2002年6月,95例I期和II期霍奇金淋巴瘤患者接受了六个周期的ABVD治疗。15例符合纵隔大肿块疾病标准的患者还接受了纵隔进一步放疗。
六个周期后,89例患者(94%)显示完全缓解(CR),6例患者(6%)显示部分缓解(PR)。这些PR患者在放疗后变为CR。中位随访78个月后,14例患者复发,3例患者死亡。7年时的总生存率和无进展生存率分别为96%和84%。对于无纵隔大肿块疾病的IA期和IIA期患者,生存率分别为97%和88%。
六个周期的ABVD给药对I期和II期霍奇金淋巴瘤患者是一种有效且安全的治疗方法。