Randomized comparison of the Stanford V regimen and ABVD in the treatment of advanced Hodgkin's lymphoma: United Kingdom National Cancer Research Institute Lymphoma Group Study ISRCTN 64141244

Peter J. Hoskin, Lisa Lowry, Alan Horwich, Andrew Jack, Ben Mead, Barry W. Hancock, Paul Smith, Wendi Qian, Philippa Patrick, Bilyana Popova, Andrew Pettitt, David Cunningham, Ruth Pettengell, John Sweetenham, David Linch, Peter W.M. Johnson

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Abstract

Purpose: This multicenter, prospective, randomized controlled trial compared the efficacy and toxicity of two chemotherapy regimens in advanced Hodgkin's lymphoma (HL): the weekly alternating Stanford V and the standard, twice-weekly regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Patients and Methods: Patients had stage IIB, III, or IV disease or had stages I to IIA disease with bulky disease or other adverse features. Radiotherapy was administered in both arms to sites of previous bulk (> 5 cm) and to splenic deposits, although this was omitted in the latter part of the trial for patients achieving complete remission (CR) in the ABVD arm. A total of 520 patients were randomly assigned and were assessed for the primary outcome measure of progression-free survival (PFS). Five hundred patients received protocol treatment, and radiotherapy was administered to 73% in the Stanford V arm and to 53% in the ABVD arm. Results: The overall response rates after completion of all treatment were 91% for Stanford V and 92% for ABVD. During a median follow-up of 4.3 years, there was no evidence of a difference in projected 5-year PFS and overall survival (OS) rates (76% and 90%, respectively, for ABVD; 74% and 92%, respectively, for Stanford V). More pulmonary toxicity was reported for ABVD, whereas other toxicities were more frequent with Stanford V. Conclusion: In a large, randomized trial, the efficacies of Stanford V and ABVD were comparable when given in combination with appropriate radiotherapy.

Original languageEnglish (US)
Pages (from-to)5390-5396
Number of pages7
JournalJournal of Clinical Oncology
Volume27
Issue number32
DOIs
Publication statusPublished - Nov 10 2009
Externally publishedYes

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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