Influence of dose intensity and density on therapeutic and toxic effects in Hodgkin's disease

Br J Cancer. 1989 Apr;59(4):645-9. doi: 10.1038/bjc.1989.131.

Abstract

From 1972 to 1976, 95 patients with clinical stages I-IIIA Hodgkin's disease were treated by chemotherapy with cyclophosphamide, vinblastine, procarbazine and prednisone (CVPP) before and after extended field radiotherapy. The CVPP schedule gave: (1) a constant drug dosage for each patient independent of body surface or weight; and (2) a total drug dosage dependent on haematological tolerance, since the treatment was given for 21 days or until the leukocyte count dropped to 2 x 10(9) l-1. The drug dosage per unit body surface (or 'dose density') significantly correlates with the drop in leukocyte count (P less than 0.001) and the tumour regression at the end of the induction course (P = 0.020). Disease-free survival is significantly related to dose density (P = 0.050) but not to dose intensity calculated on the duration of treatment (P = 0.240). However, after exclusion of three marginal recurrences due to border-line radiotherapy, the dose intensity significantly correlates with the disease-free survival (P = 0.031) and with the duration of complete remission (r = 0.870).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Drug Administration Schedule
  • Hodgkin Disease / drug therapy*
  • Humans
  • Leukocyte Count / drug effects
  • Lomustine / administration & dosage
  • Lomustine / adverse effects
  • Prednisone / administration & dosage
  • Prednisone / adverse effects
  • Procarbazine / administration & dosage
  • Procarbazine / adverse effects
  • Vinblastine / administration & dosage
  • Vinblastine / adverse effects

Substances

  • Procarbazine
  • Vinblastine
  • Lomustine
  • Prednisone

Supplementary concepts

  • CVPP protocol