Bonadonna G, Zucali R, Monfardini S, De Lena M, Uslenghi C
Cancer. 1975 Jul;36(1):252-9. doi: 10.1002/1097-0142(197507)36:1<252::aid-cncr2820360128>3.0.co;2-7.
This paper reports the preliminary results of a controlled study randomizing MOPP vs. a new four-drug combination (ABVD) in advanced Hodgkin's disease. ABVD consists of 6 cycles of adriamycin, bleomycin, vinblastine, and imidazole carboxamide. The purpose for designing this new combination was two-fold: to compare the efficacy of ABVD with MOPP, and to demonstrate absence of cross-resistance between the two regimens. Of 60 patients entered into the study, 45 (MOPP25, ABVD20) are presently evaluable for the analysis of remission induction. No patient was previously treated with chemotherapy; 20% had relapsed after primary radiotherapy. Whenever possible, complete remission was defined also through rebiopsy of known organ involvement. Complete remission occurred in 76% of patients treated with MOPP and in 75% of those given ABVD, with no difference between the two regimens as far as stage (IIIB-IIIS and IV), histologic type, and prior irradiation were concerned. Crossover carried out for progressive disease or for relapse after initial remission showed absence of cross-resistance between MOPP and ABVD. Toxic manifestations after ABVD were in general well tolerated and reversible. The percent of optimal dose for each drug was as follows: adriamycin 87%, vinblastine 87%, bleomycin 96%, and imidazole carboxamide 96%. These preliminary results indicate that in terms of complete remission, ABVD could represent a successful alternative to MOPP to be used either in MOPP failures or in sequential combination with MOPP. However, the lack of long-term followup limits at the present time an adequate comparison between the two treatments.
本文报告了一项对照研究的初步结果，该研究将MOPP方案与一种新的四联药物组合（ABVD）用于晚期霍奇金病患者并进行随机分组。ABVD方案由6个周期的阿霉素、博来霉素、长春花碱和咪唑甲酰胺组成。设计这种新组合的目的有两个：一是比较ABVD与MOPP的疗效，二是证明两种方案之间不存在交叉耐药性。在进入该研究的60例患者中，目前有45例（MOPP方案组25例，ABVD方案组20例）可用于缓解诱导分析。此前所有患者均未接受过化疗；20%的患者在接受初次放疗后复发。只要有可能，完全缓解也通过对已知受累器官进行再次活检来确定。接受MOPP方案治疗的患者中76%达到完全缓解，接受ABVD方案治疗的患者中75%达到完全缓解，就分期（IIIB-IIIS期和IV期）、组织学类型和既往放疗情况而言，两种方案之间没有差异。对疾病进展或初次缓解后复发的患者进行交叉治疗显示，MOPP和ABVD之间不存在交叉耐药性。ABVD方案后的毒副反应总体上耐受性良好且可逆转。每种药物的最佳剂量百分比分别如下：阿霉素87%，长春花碱87%，博来霉素96%，咪唑甲酰胺96%。这些初步结果表明，就完全缓解而言，ABVD可作为MOPP方案失败时或与MOPP方案序贯联合使用时的一种成功替代方案。然而，目前缺乏长期随访，限制了两种治疗方法之间的充分比较。
