Möglichkeiten einer Therapiereduktion bei Morbus Hodgkin: III. Kann die Polychemotherapie bei einer kombinierten Chemo-Strahlentherapie lokalisierter Stadien verringert werden?

Résumé fourni par la source

The effectiveness of three and six cycles of MOPP (chlormethine, vincristine, procarbazine and prednisolone) as initial chemotherapy in 108 patients with Hodgkin's disease at clinical stages II nA, IIB, IIIA and B was compared in a study of two groups, one of them treated in six cycles (October, 1972--December, 1976), the other in three cycles (January, 1977--October, 1979). The clinically complete remissions obtained by this schedule and findings at exploratory splenectomy were chosen as measures of effectiveness. The frequency of clinically complete remission was similar in both groups. In 96% (97% for the second group) of patients in whom the three (six) MOPP cycles of cytostatic treatment achieved clinically complete remission, exploratory splenectomy failed to reveal any infradiaphragmatic involvement. In patients in stage IIA and IIB one can, therefore, consider reducing primary cytostatic treatment to three MOPP cycles. Exploratory splenectomy and prophylactic infradiaphragmatic radiotherapy can be omitted in these patients, if one accepts the 5% risk of infradiaphragmatic involvement. Splenectomy can also be omitted in patients in stage III, but not infradiaphragmatic radiotherapy, including that no the spleen.

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