Article,

Participation in multicenter studies as quality control in the therapy of Hodgkin disease: an interim report

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Schweizerische medizinische Wochenschrift, 125 (6): 217–224 (1995)

Abstract

From 1988 to 1992 the Swiss Group for Clinical Cancer Research (SAKK) entered 113 patients with Hodgkin's disease into three stage adapted trials (HD-4-6) from the German Hodgkin Study Group (DHSG). In an interim analysis freedom from treatment failure (FFTF) and overall survival (OS) of the SAKK patients (SAKK-pt) were compared to the remaining study population (GHSH-pt) (median follow-up: 30 months for HD-4 and HD-5, 24 months for HD-6). RESULTS: HD-4: SAKK (n = 16), DHSG (n = 241), FFTF-SAKK: 100\%, FFTF-DHSG: 85\%, p: ns, OS-SAKK: 100\%, OS-DHSG: 99\%, p: ns, HD-5: SAKK (n = 66), DHSG (n = 639), FFTF-SAKK: 90\%, FFTF-DHSG: 85\%, p: ns, OS-SAKK: 93\%, OS-DHSG: 95\%, p: ns, HD-6; SAKK (n = 31), DHSG (n = 411): FFTF-SAKK: 62\%, FFTF-DHSG: 68\%, p: ns, OS-SAKK: 70\%, OS-DHSG: 88\%, p < 0.008. The results in the SAKK patients with advanced disease are unsatisfactory. Despite the fact that the treatment was given on time with full doses, 10/30 patients achieved no complete remission (CR). Only one patient relapsed after an initial CR. 6 patients had primary progressive disease. 6 patients died despite conventional salvage chemotherapy. High dose chemotherapy/autologous bone marrow transplantation (HDC/ABMT) was only given to 3 out of 8 potential candidates. Only 2/11 patients are still alive and disease-free after relapse or initial progression. Both had received HDC/ABMT as part of their salvage regimen. This interim analysis identifies a group of patients in which treatment strategies need to be optimized.

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