Reduced-Intensity Chemo Effective in Hodgkin's

Six cycles of BEACOPPescalated more effective and less toxic than eight cycles

WEDNESDAY, April 4 (HealthDay News) -- Treating patients with advanced-stage Hodgkin's lymphoma with a reduced-intensity, six-cycle BEACOPPescalated chemotherapy regimen is more effective and less toxic than eight cycles of the same regimen, according to a study published online April 4 in The Lancet.

Andreas Engert, M.D., of the University Hospital of Cologne in Köln, Germany, and colleagues conducted a multicenter, open-label, parallel-group, non-inferiority trial involving 2,126 intention-to-treat patients with newly diagnosed advanced stage Hodgkin's lymphoma. Patients were treated with eight cycles of reduced-intensity BEACOPPescalated (8×Besc; 705 patients), six cycles of BEACOPPescalated (6×Besc;711 patients), or eight cycles of BEACOPP14 (8×B14; 710 patients). Patients who had a persistent mass after completing chemotherapy were treated with 30 Gy radiation.

The researchers found that the five-year freedom from treatment failure rates were 84.4 percent for 8×Besc, 89.3 percent for 6×Besc, and 85.4 percent for 8×B14, indicating that freedom from treatment failure was non-inferior in the 6×Besc and 8×B14 groups compared with 8×Besc. The overall survival was significantly better for 6×Besc than for 8×Besc (91.9 percent for 8×Besc, 95.3 percent for 6×Besc, and 94.5 percent for 8×B14). The higher mortality in the 8×Besc group was mainly attributable to treatment-related adverse events (2.1, 0.8, and 0.8 percent, respectively) and secondary malignancies (1.8, 0.7, and 1.1 percent, respectively). At one year, the negative predictive value for tumor recurrence using positron emission tomography (PET), an independent end point, was 94.1 percent.

"Treatment with six cycles of BEACOPPescalated followed by PET-guided radiotherapy was more effective in terms of freedom from treatment failure and less toxic than eight cycles of the same chemotherapy regimen," the authors write.

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