Table 2.
Sequential therapeutic protocols for newly diagnosed Hodgkin’s lymphoma, 1975–2008
| Protocol | Eligibility | Chemotherapy | Cycles | Radiation dose |
Radiation field |
Number enrolled |
|---|---|---|---|---|---|---|
| 75–103 | Stage I, II | MOPP | 6 (sandwich) | 3500 cGy | IFRT | 82 |
| 75–104 | Stage IIB, III, IV | MOPP/ABVD | 6 | 2000–3000 cGy* | IFRT | 69 |
| 79-017 | Stage IIB, III, IV | MOPP/ABV/CAD | 9 (sandwich RT) | 2000–3000 cGy* | EFRT† | 116 |
| MOPP/ABVD | 9 (sandwich RT) | 2000–3000 cGy* | EFRT† | 111 | ||
| 81–103 | Stage I, II, IIIA | MOPP | 4 (sandwich RT) | 3600 cGy | EFRT† | 89 |
| TBV | 4 (sandwich RT) | 3600 cGy | EFRT† | 80 | ||
| 90-044 | Stage I, II, IIIA | ABVD | 6 | none | n/a | 76 |
| 3600 cGy | EFRT†or IFRT‡ | 77 | ||||
| 91-069 | Stage IIB, III, IV | ABVD | 6 | 3600 cGy | IFRT | 23 |
| 3600 cGy | EFRT† | 23 | ||||
* All patients received 2000 cGy to extended fields. Patients with bulk at diagnosis received 1000 cGy boosts to site(s) of bulk. ABV = doxorubicin, bleomycin, vinblastine; ABVD = doxorubicin, bleomycin, vinblastine, dacarbazine; CAD = lomustine, doxorubicin, vindesine; EFRT = extended field radiotherapy; IFRT = involved field radiotherapy; MOPP = mechlorethamine, vincristine, procarbazine, prednisone; RT = radiotherapy; TBV = thiotepa, bleomycin, vinblastine.
† Extended fields consisted of mantle for supradiaphragmatic disease, inverted-Y plus spleen or splenic pedicle for infradiaphragmatic disease, and total lymphoid irradiation.
‡ Radiation fields were changed during study to align with guidelines favoring involved field radiotherapy. Eleven patients received IFRT, the remainder EFRT.