A randomized study in stage IIIB and IV XXXX comparing eight courses of MOPP versus an alteration of MOPP with ABVD: a European Organization for Research and Treatment of Cancer Lymphoma Cooperative Group and Groupe Pierre-et-Marie-Curie controlled clinical trial.

@entity632 @entity1 @entity10911 @entity4174 @entity22979 @entity4557 @entity2699 @entity229 @entity1891 @entity1732 @entity3700 @entity5713 @entity978
PURPOSE: We report a prospective randomized study comparing the relative efficacy of alternating chemotherapy @entity3700 , @entity1891 , @entity4174 , and @entity229 / @entity632 , @entity1732 , @entity5713 , and @entity2699 (MOPP/ABVD) with the standard MOPP chemotherapy in @entity1 with stage IIIB and IV @entity978 ( @entity978 ). The purpose is to study the influence of time of remission on clinical outcome. @entity1 AND METHODS: After two courses of MOPP, @entity1 were randomized to receive six further courses of MOPP, or two courses of ABVD followed by two courses of MOPP and two courses of ABVD. Radiotherapy was given to areas presenting with masses > or = 5 cm and to residual masses after course no. 4. Evaluation of response (complete remission [CR]) took place after two courses ( @entity10911 ), after four courses ( @entity22979 ), at the end of chemotherapy (CR8), and after additional radiotherapy (CR(CT + RT)). Logistic regression analysis was used to study prognostic factors for response at the end of chemotherapy. Cox analysis was used to study prognostic factors for survival. Two hundred seven @entity1 were registered, 192 (93%) of whom were randomized. RESULTS: The CR rate at the end of chemotherapy (CR8) was similar in both arms (57% v 59%). However, there were more progressions in the MOPP arm compared with the MOPP/ABVD arm (23% v 8%, P = .014). A significantly higher failure-free survival (FFS) rate was found in the MOPP/ABVD arm (60% v 43% at 6 years, P = .025). There was no difference in the @entity4557 ( @entity4557 ) or survival rate. Of @entity1 not in @entity22979 , only 28% still reached a CR8. @entity4557 at 6 years of @entity1 with @entity22979 (69%) was not different from that of @entity1 with CR8 (68%); @entity1 with a CR(CT + RT)) had a lower @entity4557 rate (48%). @entity22979 (P < .001) predicted strongly for final remission at the end of chemotherapy. Cox analysis showed that age more than 50 years, six or more involved lymph node areas, no CR by the fourth cycle, chemotherapy with MOPP alone, and no radiotherapy were unfavorable factors for survival. CONCLUSION: MOPP/ABVD chemotherapy significantly improved response and FFS rates, but had no influence on @entity4557 and survival rates. Early CR ( @entity22979 ) is an important factor for final remission and might be used to select a group of @entity1 with a good prognosis.
