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Meta-Analysis
. 2005 Oct 19;2005(4):CD003187.
doi: 10.1002/14651858.CD003187.pub2.

Chemotherapy, radiotherapy and combined modality for Hodgkin's disease, with emphasis on second cancer risk

J G Franklin  1 , M D Paus, A Pluetschow, L Specht
Affiliations
Meta-Analysis

Chemotherapy, radiotherapy and combined modality for Hodgkin's disease, with emphasis on second cancer risk

J G Franklin et al. Cochrane Database Syst Rev. .

Abstract

Background: Second malignancies (SM) are a major late effect of treatment for Hodgkin's disease (HD). Reliable comparisons of SM risk between alternative treatment strategies are lacking.

Objectives: Radiotherapy (RT), chemotherapy (CT) and combined chemo-radiotherapy (CRT) for newly-diagnosed Hodgkin's disease are compared with respect to SM risk, overall (OS) and progression-free (PFS) survival. Further, involved-field (IF-)RT is compared to extended-field (EF-)RT.

Search strategy: We searched the Cochrane Controlled Trials Register, PubMed, EMBASE, CancerLit, LILACS, relevant conference proceedings, trials lists and publications.

Selection criteria: RCTs accruing 30+ patients and completing accrual before/during 2000, comparing at least two treatment modalities for newly-diagnosed HD.

Data collection and analysis: Individual patient data were collected and assessed for data quality. Trialists submitted additional information concerning methods and data quality. Peto Odds Ratios (OR) with 95% confidence intervals (CI) were calculated for OS, PFS and SM-free survival. Secondary acute leukemia (AL), non-Hodgkin's lymphoma (NHL) and solid tumours (ST) were also analysed separately.

Main results: 37 trials (9312 patients) were analysed: 15 (3343) for RT vs. CRT, 16 (2861) for CT vs. CRT, 3 (415) for RT vs. CT and 10 (3221) for IF-RT vs. EF-RT.CRT was superior to RT in terms of OS (OR=0.76, CI=0.66 to 0.89, p=0.0004), PFS (OR=0.49, CI=0.43 to 0.56, p<0.0001) and SM (OR=0.78. CI=0.62 to 0.98, p=0.03). The superiority of CRT also applied to early and advanced stages (mainly IIIA) separately. Excess SM with RT is due mainly to ST and is apparently caused by greater need for salvage therapy after RT.CRT was superior to CT in terms of PFS (OR=77, CI 0.68 to 0.77, p<0.0001). OS was better with CRT for early stages only (OR=0.62, CI 0.44 to 0.88, p=0.006). SM risk was higher with CRT (OR=1.38, CI 1.00 to 1.89, p=0.05), although not significant for early stages alone. This effect, also seen in AL and ST separately, was due directly to first-line treatment. Data were insufficient to compare RT to CT.EF-RT was superior to IF-RT (each additional to CT in most trials) in terms of PFS (OR=81, CI 0.68 to 0.95, p=0.009) but not OS. No significant difference in SM was observed.

Authors' conclusions: CRT seems to be optimal for most early stage (I-II) HD patients. For advanced stages (III-IV), CRT better prevents progression/relapse but CT alone seems to cause less SM. RT alone gives a higher overall SM risk than CRT due to increased need for salvage therapy. Reduced SM risk after IF-RT instead of EF-RT could not be demonstrated. Due to the large number of studies excluded because no IPD were received, to the inclusion of many outdated treatments and to the limited amount of long-term data, one must be cautious in applying these results to current therapies.

PubMed Disclaimer

Conflict of interest statement

There is no known conflict of interest.

Figures

1
1
Forest plot of comparison: 3 RT v CRT, outcome: 3.7 progression free survival.
2
2
Forest plot of comparison: 3 RT v CRT, outcome: 3.1 overall survival.
3
3
Forest plot of comparison: 3 RT v CRT, outcome: 3.14 second malignancy free survival.
4
4
RT v CRT SM Peto. Graphs of Peto estimated cumulative SM rates comparing RT with CRT. Left: all SM; right: censored at relapse or progression of HD. Below each graph the numbers of patients still 'at risk' are displayed.
5
5
Forest plot of comparison: 3 RT v CRT, outcome: 3.26 solid tumors.
6
6
Forest plot of comparison: 3 RT v CRT, outcome: 3.34 NHL ‐ early stages only.
7
7
Forest plot of comparison: 3 RT v CRT, outcome: 3.32 AML/MDS ‐ early stages only.
8
8
Forest plot of comparison: 3 RT v CRT, outcome: 3.18 SM before progression/relapse.
9
9
RT v CRT SM CRisks. Graphs of competing risks cumulative SM incidences comparing RT with CRT. Left: all SM; right: censored at relapse or progression of HD. Below each graph the numbers of patients still 'at risk' are displayed.
10
10
Forest plot of comparison: 3 RT v CRT, outcome: 3.28 solid tumors before progression/relapse.
11
11
Forest plot of comparison: 3 RT v CRT, outcome: 3.35 NHL before progression/relapse.
12
12
Forest plot of comparison: 3 RT v CRT, outcome: 3.33 AML/MDS before progression/relapse.
13
13
Forest plot of comparison: 2 CT v CRT, outcome: 2.10 progression free survival.
14
14
Forest plot of comparison: 2 CT v CRT, outcome: 2.1 overall survival.
15
15
Forest plot of comparison: 2 CT v CRT, outcome: 2.17 second malignancy free survival.
16
16
CT v CRT SM Peto. Graphs of Peto estimated cumulative SM rates comparing CT with CRT. Left: all SM; right: censored at relapse or progression of HD. Below each graph the numbers of patients still 'at risk' are displayed.
17
17
Forest plot of comparison: 2 CT v CRT, outcome: 2.33 AML/MDS.
18
18
Forest plot of comparison: 2 CT v CRT, outcome: 2.35 NHL.
19
19
Forest plot of comparison: 2 CT v CRT, outcome: 2.28 solid tumors.
20
20
Forest plot of comparison: 2 CT v CRT, outcome: 2.21 SM before progression or relapse.
21
21
Forest plot of comparison: 2 CT v CRT, outcome: 2.30 solid tumors before progression/relapse.
22
22
Forest plot of comparison: 2 CT v CRT, outcome: 2.34 AML/MDS before progression/relapse.
23
23
Forest plot of comparison: 2 CT v CRT, outcome: 2.36 NHL before progression/relapse.
24
24
CT v CRT SM CRisks. Graphs of competing risks cumulative SM incidences comparing CT with CRT. Left: all SM; right: censored at relapse or progression of HD. Below each graph the numbers of patients still 'at risk' are displayed.
25
25
Forest plot of comparison: 1 RT vs. CT, outcome: 1.4 progression free survival.
26
26
Forest plot of comparison: 1 RT vs. CT, outcome: 1.1 overall survival.
27
27
Forest plot of comparison: 1 RT vs. CT, outcome: 1.8 second malignancy free survival.
28
28
RT v CT SM Peto. Graphs of Peto estimated cumulative SM rates comparing RT with CT. Left: all SM; right: censored at relapse or progression of HD. Below each graph the numbers of patients still 'at risk' are displayed.
29
29
Forest plot of comparison: 1 RT vs. CT, outcome: 1.9 SM before progression/relapse.
30
30
Forest plot of comparison: 4 IF‐RT vs. EF‐RT, outcome: 4.8 progression free survival.
31
31
Forest plot of comparison: 4 IF‐RT vs. EF‐RT, outcome: 4.1 overall survival.
32
32
Forest plot of comparison: 4 IF‐RT vs. EF‐RT, outcome: 4.16 second malignancy free survival.
33
33
IF v EF SM Peto. Graphs of Peto estimated cumulative SM rates comparing IF‐RT with EF‐RT. Left: all SM; right: censored at relapse or progression of HD. Below each graph the numbers of patients still 'at risk' are displayed.
34
34
Forest plot of comparison: 4 IF‐RT vs. EF‐RT, outcome: 4.32 AML/MDS.
35
35
Forest plot of comparison: 4 IF‐RT vs. EF‐RT, outcome: 4.33 NHL.
36
36
Forest plot of comparison: 4 IF‐RT vs. EF‐RT, outcome: 4.27 solid tumors.
37
37
Forest plot of comparison: 4 IF‐RT vs. EF‐RT, outcome: 4.20 SM before progression or relapse.
38
38
IF v EF SM CRisks. Graphs of competing risks cumulative SM incidences comparing IF‐RT with EF‐RT. Left: all SM; right: censored at relapse or progression of HD. Below each graph the numbers of patients still 'at risk' are displayed.
1.1
1.1. Analysis
Comparison 1 RT vs. CT, Outcome 1 overall survival.
1.2
1.2. Analysis
Comparison 1 RT vs. CT, Outcome 2 OS ‐ early stages ‐ sex.
1.3
1.3. Analysis
Comparison 1 RT vs. CT, Outcome 3 OS ‐ advanced stages ‐ sex.
1.4
1.4. Analysis
Comparison 1 RT vs. CT, Outcome 4 progression free survival.
1.5
1.5. Analysis
Comparison 1 RT vs. CT, Outcome 5 PFS ‐ censored at cut‐off date.
1.6
1.6. Analysis
Comparison 1 RT vs. CT, Outcome 6 PFS ‐ early stages ‐ sex.
1.7
1.7. Analysis
Comparison 1 RT vs. CT, Outcome 7 PFS ‐ advanced stages ‐ sex.
1.8
1.8. Analysis
Comparison 1 RT vs. CT, Outcome 8 second malignancy free survival.
1.9
1.9. Analysis
Comparison 1 RT vs. CT, Outcome 9 SM before progression/relapse.
1.10
1.10. Analysis
Comparison 1 RT vs. CT, Outcome 10 SM free survival ‐ early stages ‐ sex.
1.11
1.11. Analysis
Comparison 1 RT vs. CT, Outcome 11 SM free survival ‐ advanced stages ‐ sex.
2.1
2.1. Analysis
Comparison 2 CT v CRT, Outcome 1 overall survival.
2.2
2.2. Analysis
Comparison 2 CT v CRT, Outcome 2 OS ‐ unconfounded trials.
2.3
2.3. Analysis
Comparison 2 CT v CRT, Outcome 3 OS ‐ early stages ‐ sex.
2.4
2.4. Analysis
Comparison 2 CT v CRT, Outcome 4 OS ‐ advanced stages ‐ sex.
2.5
2.5. Analysis
Comparison 2 CT v CRT, Outcome 5 OS‐ early stages ‐ age.
2.6
2.6. Analysis
Comparison 2 CT v CRT, Outcome 6 OS ‐ advanced stages ‐ age.
2.7
2.7. Analysis
Comparison 2 CT v CRT, Outcome 7 OS ‐ early stages ‐ type of RT.
2.8
2.8. Analysis
Comparison 2 CT v CRT, Outcome 8 OS ‐ advanced stages ‐ type of RT.
2.9
2.9. Analysis
Comparison 2 CT v CRT, Outcome 9 PFS confounded advanced.
2.10
2.10. Analysis
Comparison 2 CT v CRT, Outcome 10 progression free survival.
2.11
2.11. Analysis
Comparison 2 CT v CRT, Outcome 11 PFS ‐ censored at cut‐off date.
2.12
2.12. Analysis
Comparison 2 CT v CRT, Outcome 12 PFS ‐ unconfounded trials only.
2.13
2.13. Analysis
Comparison 2 CT v CRT, Outcome 13 PFS ‐ early stages ‐ sex.
2.14
2.14. Analysis
Comparison 2 CT v CRT, Outcome 14 PFS ‐ advanced stages ‐ sex.
2.15
2.15. Analysis
Comparison 2 CT v CRT, Outcome 15 PFS ‐ early stages ‐ age.
2.16
2.16. Analysis
Comparison 2 CT v CRT, Outcome 16 PFS ‐ advanced stages ‐ age.
2.17
2.17. Analysis
Comparison 2 CT v CRT, Outcome 17 second malignancy free survival.
2.18
2.18. Analysis
Comparison 2 CT v CRT, Outcome 18 SM free survival ‐ censored at cut‐off date.
2.19
2.19. Analysis
Comparison 2 CT v CRT, Outcome 19 SM free survival ‐ unconfounded trials only.
2.20
2.20. Analysis
Comparison 2 CT v CRT, Outcome 20 SM free survival ‐ confounded trials only.
2.21
2.21. Analysis
Comparison 2 CT v CRT, Outcome 21 SM before progression or relapse.
2.22
2.22. Analysis
Comparison 2 CT v CRT, Outcome 22 SM free survival ‐ early stages ‐ sex.
2.23
2.23. Analysis
Comparison 2 CT v CRT, Outcome 23 SM free survival ‐ advanced stages ‐ sex.
2.24
2.24. Analysis
Comparison 2 CT v CRT, Outcome 24 SM free survival ‐ early stages ‐ age.
2.25
2.25. Analysis
Comparison 2 CT v CRT, Outcome 25 SM free survival ‐ advanced stages ‐ age.
2.26
2.26. Analysis
Comparison 2 CT v CRT, Outcome 26 SM free survival ‐ non‐malignant skin cancers excluded.
2.27
2.27. Analysis
Comparison 2 CT v CRT, Outcome 27 SM before progression/relapse ‐ non‐malignant skin cancers excluded.
2.28
2.28. Analysis
Comparison 2 CT v CRT, Outcome 28 solid tumors.
2.29
2.29. Analysis
Comparison 2 CT v CRT, Outcome 29 solid tumors ‐ non‐malignant skin cancers excluded.
2.30
2.30. Analysis
Comparison 2 CT v CRT, Outcome 30 solid tumors before progression/relapse.
2.31
2.31. Analysis
Comparison 2 CT v CRT, Outcome 31 lung cancers.
2.32
2.32. Analysis
Comparison 2 CT v CRT, Outcome 32 breast cancers.
2.33
2.33. Analysis
Comparison 2 CT v CRT, Outcome 33 AML/MDS.
2.34
2.34. Analysis
Comparison 2 CT v CRT, Outcome 34 AML/MDS before progression/relapse.
2.35
2.35. Analysis
Comparison 2 CT v CRT, Outcome 35 NHL.
2.36
2.36. Analysis
Comparison 2 CT v CRT, Outcome 36 NHL before progression/relapse.
3.1
3.1. Analysis
Comparison 3 RT v CRT, Outcome 1 overall survival.
3.2
3.2. Analysis
Comparison 3 RT v CRT, Outcome 2 OS ‐ early stages ‐ sex.
3.3
3.3. Analysis
Comparison 3 RT v CRT, Outcome 3 OS ‐ advanced stages ‐ sex.
3.4
3.4. Analysis
Comparison 3 RT v CRT, Outcome 4 OS ‐ early stages ‐ age.
3.5
3.5. Analysis
Comparison 3 RT v CRT, Outcome 5 OS ‐ advanced stages ‐ age.
3.6
3.6. Analysis
Comparison 3 RT v CRT, Outcome 6 OS ‐ unconfounded trials only.
3.7
3.7. Analysis
Comparison 3 RT v CRT, Outcome 7 progression free survival.
3.8
3.8. Analysis
Comparison 3 RT v CRT, Outcome 8 PFS ‐ early stages ‐ sex.
3.9
3.9. Analysis
Comparison 3 RT v CRT, Outcome 9 PFS ‐ advanced stages ‐ sex.
3.10
3.10. Analysis
Comparison 3 RT v CRT, Outcome 10 PFS ‐ early stages ‐ age.
3.11
3.11. Analysis
Comparison 3 RT v CRT, Outcome 11 PFS ‐ advanced stages ‐ age.
3.12
3.12. Analysis
Comparison 3 RT v CRT, Outcome 12 PFS ‐ censored at cut‐off date.
3.13
3.13. Analysis
Comparison 3 RT v CRT, Outcome 13 PFS ‐ unconfounded trials only.
3.14
3.14. Analysis
Comparison 3 RT v CRT, Outcome 14 second malignancy free survival.
3.15
3.15. Analysis
Comparison 3 RT v CRT, Outcome 15 SM free survival ‐ censored at cutt‐off date.
3.16
3.16. Analysis
Comparison 3 RT v CRT, Outcome 16 SM free survival ‐ unconfounded trials only.
3.17
3.17. Analysis
Comparison 3 RT v CRT, Outcome 17 SM free survival ‐ confounded trials only.
3.18
3.18. Analysis
Comparison 3 RT v CRT, Outcome 18 SM before progression/relapse.
3.19
3.19. Analysis
Comparison 3 RT v CRT, Outcome 19 SM free survival ‐ early stages ‐ sex.
3.20
3.20. Analysis
Comparison 3 RT v CRT, Outcome 20 SM free survival ‐ advanced stages ‐ sex.
3.21
3.21. Analysis
Comparison 3 RT v CRT, Outcome 21 SM free survival ‐ early stages ‐ age.
3.22
3.22. Analysis
Comparison 3 RT v CRT, Outcome 22 SM free survival ‐ advanced stages ‐ age.
3.23
3.23. Analysis
Comparison 3 RT v CRT, Outcome 23 SM free survival ‐ subgroup +/‐ mustargen.
3.24
3.24. Analysis
Comparison 3 RT v CRT, Outcome 24 SM free survival ‐ non‐malignant skin cancers excluded.
3.25
3.25. Analysis
Comparison 3 RT v CRT, Outcome 25 SM before progression/relapse ‐ non‐malignant skin cancers excluded.
3.26
3.26. Analysis
Comparison 3 RT v CRT, Outcome 26 solid tumors.
3.27
3.27. Analysis
Comparison 3 RT v CRT, Outcome 27 solid tumors ‐ non‐malignant skin cancers excluded.
3.28
3.28. Analysis
Comparison 3 RT v CRT, Outcome 28 solid tumors before progression/relapse.
3.29
3.29. Analysis
Comparison 3 RT v CRT, Outcome 29 lung cancers.
3.30
3.30. Analysis
Comparison 3 RT v CRT, Outcome 30 lung cancers before prog/rel.
3.31
3.31. Analysis
Comparison 3 RT v CRT, Outcome 31 breast cancers.
3.32
3.32. Analysis
Comparison 3 RT v CRT, Outcome 32 AML/MDS ‐ early stages only.
3.33
3.33. Analysis
Comparison 3 RT v CRT, Outcome 33 AML/MDS before progression/relapse.
3.34
3.34. Analysis
Comparison 3 RT v CRT, Outcome 34 NHL ‐ early stages only.
3.35
3.35. Analysis
Comparison 3 RT v CRT, Outcome 35 NHL before progression/relapse.
4.1
4.1. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 1 overall survival.
4.2
4.2. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 2 OS ‐ RT plus CT.
4.3
4.3. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 3 OS ‐ RT without CT.
4.4
4.4. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 4 OS ‐ early stages ‐ sex.
4.5
4.5. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 5 OS ‐ advanced stages ‐ sex.
4.6
4.6. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 6 OS ‐ early stages ‐ age.
4.7
4.7. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 7 OS ‐ advanced stages ‐ age.
4.8
4.8. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 8 progression free survival.
4.9
4.9. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 9 PFS ‐ censored at cut‐off date.
4.10
4.10. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 10 PFS ‐ RT plus CT.
4.11
4.11. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 11 PFS ‐ RT without CT.
4.12
4.12. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 12 PFS ‐ early stages ‐ sex.
4.13
4.13. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 13 PFS ‐ advanced stages ‐ sex.
4.14
4.14. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 14 PFS ‐ early stages ‐ age.
4.15
4.15. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 15 PFS ‐ advanced stages ‐ age.
4.16
4.16. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 16 second malignancy free survival.
4.17
4.17. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 17 SM free survival ‐ censored at cut‐off date.
4.18
4.18. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 18 SM free survival ‐ RT plus CT.
4.19
4.19. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 19 SM free survival ‐ RT without CT.
4.20
4.20. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 20 SM before progression or relapse.
4.21
4.21. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 21 SM free survival ‐ early stages ‐ sex.
4.22
4.22. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 22 SM free survival ‐ advanced stages ‐ sex.
4.23
4.23. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 23 SM free survival ‐ early stages ‐ age.
4.24
4.24. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 24 SM free survival ‐ advanced stages ‐ age.
4.25
4.25. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 25 SM free survival ‐ non‐malignant skin cancers excluded.
4.26
4.26. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 26 SM before progression/relapse ‐ non‐malignant skin cancers excluded.
4.27
4.27. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 27 solid tumors.
4.28
4.28. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 28 solid tumors before progression/relapse.
4.29
4.29. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 29 solid tumors ‐ non‐malignant skin cancers excluded.
4.30
4.30. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 30 breast cancers.
4.31
4.31. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 31 lung cancers.
4.32
4.32. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 32 AML/MDS.
4.33
4.33. Analysis
Comparison 4 IF‐RT vs. EF‐RT, Outcome 33 NHL.
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Update of

  • doi: 10.1002/14651858.CD003187

References

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    1. Carde P, Noordijk E.M, Hagenbeek A, Kluin‐Nelemans J.C, Thomas J, Tirelli U, Monconduit M, Somers R, Eghbali H, Mandard A.M, Dupouy N, Henry‐Amar M. Superiority of EBVP chemotherapy in combination with involved field irradiation (EBVP/IF) over subtotal nodal irradiation (STNI) in favorable clinical stage (CS) I‐II Hodgkin's disease: the EORTC‐GPMC H7F randomized trial. Proceedings of ASCO. 1997; Vol. 16:13a. [241]
    1. Cosset J.M, Henry‐Amar M, Meerwaldt J.H, Carde P, Noodijk E.M, Thomas J, Burgers J.M.V, Somers, R, Hayat M, Tubiana M. The EORTC trials for limited stage Hodgkin's disease. Eur J Cancer 1992;28A(11):1847‐1850. - PubMed
    1. Noordijk E.M, Carde P, Mandard A.M, Mellink W.A, Monconduit M, Eghbali H, Tirelli U, Thomas J, Somers R, Dupouy N. Preliminary results of the EORTC‐GPMC controlled clinical trial H7 in early‐stage Hodgkin's disease. EORTC Lymphoma Cooperative Group. Groupe Pierre‐et‐Marie‐Curie. Ann.Oncol. 1994;5 Suppl 2:107‐112. [209] - PubMed
EORTC‐GELA, H8F {published and unpublished data}
    1. Hagenbeek A, Eghbali H, Ferme C, Meerwaldt J.H, Divine M, Raemaekers J.M.M, et al. Three cycles of MOPP/ABV hybrid and involved ‐field irradiation is more effective than subtotal nodal irradiation in favorable supradiaphragmatic clinical stages I‐II Hodgkin's disease: Preliminary results of the EORTC‐GELA H8‐F radomized trial in 543 patients.. Blood. 2000; Vol. 96:575a, abstr. 2472.
EORTC‐GELA, H8U {published and unpublished data}
    1. Ferme C, Eghbali H, Hagenbeek A, Brice P, Meder J, Carde P, et al. MOPP/ABV (M/A) hybrid and irradiation in unfavorable supradiaphragmatic clinical stages (CS) I‐II Hodgkin's disease (HD): Comparison of three treatment modalities. Preliminary results of the EORTC‐GELA H8‐U randomized trial in 995 patients.. Blood. 2000; Vol. 96:576a, abstr. 2473.
GATLA 9‐H‐77 {published and unpublished data}
    1. Diez B, Lastiri F, Aris Cancela Me, Braier J, Richard L, Martinez Rolon J, Schvartzman E, GATLA‐GLATHEM. Radiotherapy May Be Unnecessary in Favorable Stages of Hodgkin's Disease in Children. Proceedings of ASCO 1996;15:558. [242]
    1. Pavlovsky S, Maschio M, Santarelli MT, Sackmann Muriel F, Corrado C, Garcia I, Schwarts L, Montero C, Lobo Sanahuja F, Magnasco O, Rana R, Cavagnaro F. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage I‐II Hodgkin's disease.. J Natl Cancer Inst 1988;80:1466‐1473. - PubMed
    1. Pavlovsky S, Santarelli M.T, Muriel F.S, Fernandez I, :Garcia I, Schwartz L, Montero C, Sanahuja F.L, Magnasco H, Costa A. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage III‐IV A & B Hodgkin's disease. Ann Oncol 1992;3(7):533‐537. [211] - PubMed
GELA H89 {published and unpublished data}
    1. Ferme C, Berger F, Gabarre J, Brice P, Assouline D, Ferrant A, Bordessoule D, Caillot D, Colin P, Lepage E, Coiffier B. A Randomized Trial of Chemotherapy (CT) 6 Cycles Plus High‐Dose Radiotherapy (RT) Versus CT Alone 8 Cycles in Stage IIIB‐IV Hodgkin's Disease (HD). First Interim Analysis. Proceedings of ASCO. 1995; Vol. 14:394. [243]
    1. Ferme C, Mounier N, Divine M. Current clinical trials for the treatment of adult advanced‐stage Hodgkin's disease: GELA experiences. Groupe d'Etudes des Lymphomes de l'Adulte. Ann.Oncol. 2002;13 Suppl 1:96‐97. [9120] - PubMed
    1. Ferme C, Sebban C, Hennequin C, Divine M, Lederlin P, Gabarre J, Ferrant A, Caillot D, Bordessoule D, Brice P, Moullet I, Berger F, Lepage E. Comparison of chemotherapy to radiotherapy as consolidation of complete or good partial response after six cycles of chemotherapy for patients with advanced Hodgkin's disease: results of the groupe d'etudes des lymphomes de l'Adulte H89 trial. Blood 2000;95(7):2246‐2252. [208] - PubMed
GHSG, HD3 {published and unpublished data}
    1. Diehl V, Pfreundschuh M, Loffler M, Ruhl U, Hiller E, Gerhartz H, Wilmanns W, Kirchner H, Schoppe W, Petsch S, et al. Chemotherapy of Hodgkin's lymphoma with alternating cycles of COPP (cyclophosphamide, vincristin, procarbazine, prednisone) and ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine). Results of the HD1 and HD3 trials of the German Hodgkin Study Group. Chemotherapy of Hodgkin's lymphoma with alternating cycles of COPP (cyclophosphamide, vincristin, procarbazine, prednisone) and ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine). Results of the HD1 and HD3 trials of the German Hodgkin Study Group.. Med Oncol Tumor Pharmacother 1989;6(2):155‐162. - PubMed
    1. Diehl V, Loeffler M, Pfreundschuh M, Ruehl U, Hasenclever D, Nisters‐Backes H, Sieber M, Smith K, Tesch H, Geilen W. Further chemotherapy versus low‐dose involved‐field radiotherapy as consolidation of complete remission after six cycles of alternating chemotherapy in patients with advance Hodgkin's disease. German Hodgkins' Study Group (GHSG). Ann Oncol 1995;6(9):901‐910. [227] - PubMed
GHSG, HD7 {published and unpublished data}
    1. Sieber M, Franklin J, Tesch H, Rueffer U, Brillant C, Reineke R, et al. Two cycles ABVD plus extended field radiotherapy is superior to radiotherapy alone in early stage Hodgkin's disease: results of the German Hodgkin's Lymphoma Study Group (GHSG) Trial HD7 [abstract].. Blood. 2002; Vol. 100:abstr. 341.
    1. Tesch H, Sieber M, Rüffer JU, et al. 2 cycles ABVD plus radiotherapy is more effective than radiotherapy alone in early stage HD ‐‐ Results of the HD7 trial of the GHSG.. Proceedings of the VIIth Int Conf Malignant Lymphoma. Lugano, 1999:abstr. 249.
GHSG, HD8 {published and unpublished data}
    1. Engert A, Schiller P, Josting A, Herrmann R, Koch P, Sieber M, Boissevain F, Wit M, Mezger J, Duhmke E, Willich N, Muller RP, Schmidt BF, Renner H, Muller‐Hermelink HK, Pfistner B, Wolf J, Hasenclever D, Loffler M, Diehl V, German Hodgkin's Lymphoma Study Group. Involved‐field radiotherapy is equally effective and less toxic compared with extended‐field radiotherapy after four cycles of chemotherapy in patients with early‐stage unfavorable Hodgkin's lymphoma: results of the HD8 trial of the German Hodgkin's Lymphoma Study Group.. J Clin Oncol 2003;21(19):3601‐3608. - PubMed
GPMC, EF‐RT vs. IF‐R {published and unpublished data}
    1. Zittoun R, Audebert A, Hoerni B, Bernadou A, Krulik M, Rojouan J, Eghbali H, Merle‐Beral H, Parlier Y, Diebold J. Extended versus involved fields irradiation combined with MOPP chemotherapy in early clinical stages of Hodgkin's disease. J Clin Oncol 1985;3(2):207‐214. [103] - PubMed
Lygra I {published and unpublished data}
    1. Nordentoft A.M. [Radiotherapy in 50 cases of Hodgkin's disease in stages I and II. Report from the Lymphogranulomatosis Committee (LYGRA)]. Ugeskr Laeger 1972;134(45):2382‐2385. [261] - PubMed
Lygra II {published and unpublished data}
    1. Nissen N.I, Nordentoft A.M, Brincker H, Andersen E, Jensen M.K, Nielsen J.B, Pedersen‐Bjergaard J, Jensen T.S, Jensen K.B, Videbaek A, Pedersen M, Walbom‐Jorgensen S. Radiotherapy versus radiotherapy plus chemotherapy in stages I and II Hodgkin's disease. A prospective, randomized study by the Danish National Hodgkin Study Group, LYGRA. Scand J Haematol 1980;25(1):35‐44. [233] - PubMed
    1. Nissen N.I, Nordentoft, A.M. Radiotherapy versus combined modality treatment of stage I and II Hodgkin's disease. Cancer Treat Rep 1982;66(4):799‐803. [175] - PubMed
    1. Specht L. Very long‐term follow‐up of the Danish National Hodgkin Study Groups's randomized trial of radiotherapy (RT) alone vs. combined modality treatment (CMT) for early stage Hodgkin lymphoma, with special reference to second tumours and overall survival. Blood. 2003; Vol. 102:637a.
Manchester, HD 1 {published and unpublished data}
    1. Anderson H, Crowther D, Deakin D.P, Ryder W.D, Radford J.A. A randomised study of adjuvant MVPP chemotherapy after mantle radiotherapy in pathologically staged IA‐IIB Hodgkin's disease: 10‐year follow‐up. Ann Oncol 1991;2 Suppl 2:49‐54. [207] - PubMed
    1. Anderson H, Deakin D.P, Wagstaff J, Jones J.M, Todd I.D, Wilkinson P.M, James R.D, Steward W.P, Blackledge G, Scarffe J.H. A randomised study of adjuvant chemotherapy after mantle radiotherapy in supradiaphragmatic Hodgkin's disease PS IA‐IIB: a report from the Manchester lymphoma group. Br J Cancer 1984;49(6):695‐702. [239] - PMC - PubMed
Manchester, HD 2 {published and unpublished data}
    1. Crowther D, Wagstaff J, Deakin D, Todd I, Wilkinson P, Anderson H, Blackledge G, Jones M, Scarffe J.H. A randomized study comparing chemotherapy alone with chemotherapy followed by radiotherapy in patients with pathologically staged IIIA Hodgkin's disease. J Clin Oncol 1984;2(8):892‐897. [90] - PubMed
Manchester,RT v. CRT {published and unpublished data}
    1. Radford J.A. UK studies in early stage/low‐risk Hodgkin's lymphoma. Leukemia & Lymphoma. 2001; Vol. 42 Supp 2:12‐13, abstr. I‐36.
    1. Radford J.A, Cowan R.A, Ryder W.D.J, Deakin D.P, James R.D, Wilkinson P.M, Crowther D. Four Weeks of Neo‐Adjuvant Chemotherapy Significantly Reduces the Progression Rate in Patients Treated with Limited Field Radiotherapy for Clinical Stage (CS) IA/IIA Hodgkin's Disease. Results of a Randomised Pilot Study.. Proceedings of ASCO. 1996; Vol. 15:428. [180]
    1. Radford J.A, Cowan R.A, Ryder W.D.J, Johnson R.J, Bannerjee S.S, Deakin D.P, et al. Four Weeks of VAPEC‐B chemotherapy before involved field radiotherapy minimises the relapse rate in early stage, low risk Hodgkin's disease and is not associated with an excess of second malignancy.. Ann Oncol. 2002; Vol. 13, Supp 2:25, abstr. 070. [180]
Mexico, 82HO31 {published and unpublished data}
    1. Aviles A, Delgado S. A prospective clinical trial comparing chemotherapy, radiotherapy and combined therapy in the treatment of early stage Hodgkin's disease with bulky disease. Clin Lab Haematol 1998;20(2):95‐99. [177] - PubMed
    1. Aviles A, Neri N, Cuadra I, Alvarado I, Cleto S. Second lethal events associated with treatment for Hodgkin's disease: a review of 2980 patients treated in a single Mexican institute. Leukrmia and Lymphoma 2000;39(3‐4):311‐319. [89] - PubMed
Milan, trial # 9005 {published and unpublished data}
    1. Bonfante V, Viviani S, Devizzi L, Santoro A, Russo A, Zanini M, et. al. Ten‐years experience with ABVD plus radiotherapy: subtotal nodal (STNI) vs. involved field (IF‐RT) in early‐stage Hodgkin's disease (Hd). Proceedings of ASCO. 2001; Vol. 20:281a, abstract 1120.
MSKCC, trial # 90‐44 {published and unpublished data}
    1. Hirsch A, Vander Els N, Straus D.J, Gomez E.G, Leung D, Portlock C.S, Yahalom J. Effect of ABVD chemotherapy with and without mantle or mediastinal irradiation on pulmonary function and symptoms in early‐stage Hodgkin's disease. J Clin Oncol 1996;14(4):1297‐1305. [170] - PubMed
    1. Straus D.J, Yahalom J, Zelenetz A, Qin J, Myers J, Moskowitz C.H, et al. Results of a prospective randomized trial of Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine (ABVD) alone vs. ABVD + radiation therapy for early stage non bulky Hodgkin's disease.. Blood. 2001; Vol. 98:769a, abstr. 3201. - PubMed
NCI Canada, HD1 {published and unpublished data}
    1. Yelle L, Bergsagel D, Basco V, Brown T, Bush R, Gillies J, Israels L, Miller A, Rideout D, Whitelaw D. Combined modality therapy of Hodgkin's disease: 10‐year results of National Cancer Institute of Canada Clinical Trials Group multicenter clinical trial. J Clin Oncol 1991;9(11):1983‐1993. [197] - PubMed
Obninsk, advanced {published and unpublished data}
    1. Baisogolov G.D, Isaev I.G, Pavlov V.V. [Late results of drug and combined (chemo‐ and radiation) therapy of patients with stages IIIB‐IV of lymphogranulomatosis]. Med Radiol Mosc 1980;1:32‐36. - PubMed
Obninsk, R 18 {published and unpublished data}
    1. Baisogolov G.D, Khmelevskaia Z.I, Shakhtarina S.V. [Combined radio‐ and chemotherapy of patients with stage I‐II lymphogranulomatosis]. Ter Arkh 1981;53(9):144‐146. [7616] - PubMed
    1. Baysogolov G.D, Shakhtarina S.V. The efficiency of different combined treatment programs (combination chemotherapy‐radiotherapy) used for stage I‐II Hodgkin's disease. Radiother Oncol 1987;8(2):113‐122. [260] - PubMed
Rome, Florence, 1979 {published and unpublished data}
    1. Biti G.P, Cimino G, Cartoni C, Magrini S.M, Anselmo A.P, Enrici R.M, Bellesi G.P, Bosi A, Papa G, Giannarelli D. Extended‐field radiotherapy is superior to MOPP chemotherapy for the treatment of pathologic stage I‐IIA Hodgkin's disease: eight‐year update of an Italian prospective randomized study. J Clin Oncol 1992;10(3):378‐382. [219] - PubMed
    1. Cimino G, Biti G.P, Anselmo A.P, Maurizi‐Enrici R, Bellesi G.P, Bosi A, Cionini L, Mungai V, Papa G, Ponticelli P. MOPP chemotherapy versus extended‐field radiotherapy in the management of pathological stages I‐IIA Hodgkin's disease. J Clin Oncol 1989;7(6):732‐737. [5727] - PubMed
    1. Mandelli F, Anselmo A.P, Cartoni C, Cimino G, Maurizi‐Enrici R, Biagini C. Evaluation of therapeutic modalities in the control of Hodgkin's disease. Int J Radiat Oncol Biol Phys 1986;12(9):1617‐1620. [206] - PubMed
Rome, HD 94 {published and unpublished data}
    1. Anselmo A.P, Cantonetti M, Proia S, Cartoni C, Donato V, Bellesi M, Enrici R.M. Involved‐field radiotherapy (I.F.) vs extended‐field radiotherapy (E.F.) after ABVD chemotherapy in intermediate stage Hodgkin's disease (HD) Preliminary results. Ann Oncol. 1996; Vol. 7, suppl. 3:12, abstr. 411.
Rome, RT vs. CRT {published and unpublished data}
    1. Anselmo A.P, Bove M, Cartoni C, Damico C, Enrici R.M, Osti F.M, Biagini C. Combined modality (ABVD plus radiotherapy) versus radiotherapy in the management of early stage (IIA) Hodgkin's disease with mediastinal involvement. Haematologica 1992;77(2):177‐179. [215] - PubMed
SJCRH, HD study II B {published and unpublished data}
    1. Thompson E, Smith K, Wilimas J, Kumar M. Radiation, Chemotherapy, or both in Childhood and Adolescent Hodgkin's Disease (HD). Proceedings of the.Am Assoc Cancer Res.. 1977; Vol. 18, issue 221:abstr. 881. [273]
SJCRH, HD Study IIC {published and unpublished data}
    1. Thompson E, Smith K, Wilimas J, Kumar M. Radiation, Chemotherapy, or both in Childhood and Adolescent Hodgkin's Disease (HD). Proceedings of the .Am Ass Cancer Res. 1977; Vol. 18, issue 221:abstr. 881. [273]
Stanf. C1‐C3, G1 {published and unpublished data}
    1. Hoppe R.T, Horning S.J, Hancock S.L, Rosenberg S.A. Current Stanford clinical trials for Hodgkin's disease. Recent Results Cancer Res. 1989;117:182‐190. [205] - PubMed
    1. Hoppe R.T, Horning S.J, Rosenberg S.A. The concept, evolution and preliminary results of the current Stanford clinical trials for Hodgkin's disease. Cancer Surv 1985;4(2):459‐475. [3] - PubMed
    1. Horning S.J. The Stanford Hodgkin's disease (HD) studies‐‐an update. Leukemia 1991;5 Suppl 1:53‐55. [203] - PubMed
    1. Horning S.J, Hoppe R.T, Hancock S.L, Rosenberg S.A. Vinblastine, bleomycin, and methotrexate: an effective adjuvant in favorable Hodgkin's disease. J Clin Oncol 1988;6(12):1822‐1831. [204] - PubMed
    1. Horning S.J, Hoppe R.T, Mason J, Brown B.W, Hancock S.L, Baer D, Rosenberg S.A. Stanford‐Kaiser Permanente G1 study for clinical stage I to IIA Hodgkin's disease: Subtotal lymphoid irradiation versus Vinblastine, Methotrexate, and Bleomcyn chemotherapy and regional irradiation. J Clin Oncol 1997;15(5):1736‐1744. - PubMed
Stanf. C7‐10, C12‐15 {published and unpublished data}
    1. Hoppe R.T, Horning S.J, Hancock S.L, Rosenberg S.A. Current Stanford clinical trials for Hodgkin's disease. Recent Results Cancer Res 1989;117:182‐190. [205] - PubMed
    1. Hoppe R.T, Horning S.J, Rosenberg S.A. The concept, evolution and preliminary results of the current Stanford clinical trials for Hodgkin's disease. Cancer Surv 1985;4(2):459‐475. [3] - PubMed
    1. Rosenberg S.A. The Current Status of the Stanford Randomized Trials of the Management of Hodgkin's Disease. Proceedings of the Second International Conference on Malignant Lymphomas, Lugano, Switzerland, June 13‐16, 1984: Malignant Lymphomas and Hodgkin's Disease: Experimental and Therapeutic Advances. Boston: Martinus Nijhoff Publishing, 1985, issue VI. 1.:281‐292. [245]
    1. Rosenberg S.A, Kaplan H.S. The evolution and summary results of the Stanford randomized clinical trials of the management of Hodgkin's disease: 1962‐1984. Int J Radiat Oncol Biol Phys 1985;11(1):5‐22. [71] - PubMed
Stanf. H1, L1, L2 {published and unpublished data}
    1. Hoppe R.T, Horning S.J, Hancock S.L, Rosenberg S.A. Current Stanford clinical trials for Hodgkin's disease. Recent Results Cancer Res 1989;117:182‐190. [205] - PubMed
    1. Hoppe R.T, Horning S.J, Rosenberg S.A. The concept, evolution and preliminary results of the current Stanford clinical trials for Hodgkin's disease. Cancer Surv 1985;4(2):459‐475. [3] - PubMed
    1. Kaplan H.S, Rosenberg S.A. Extended‐field radical radiotherapy in advanced Hodgkin's disease: short‐term results of 2 randomized clinical trials. Cancer Res 1966;26(6):1268‐1276. [249] - PubMed
    1. Kaplan H.S, Rosenberg S.A. International Symposium on Hodgkin's Disease. Session 5. Treatment. Current status of clinical trials: Stanford experience, 1962‐72.PG ‐. Natl Cancer Inst Monogr 1973;36:363‐371. [8791] - PubMed
    1. Rosenberg S.A. The Current Status of the Stanford Randomized Trials of the Management of Hodgkin's Disease. Proceedings of the Second International Conference on Malignant Lymphomas, Lugano, Switzerland, June 13‐16, 1984: Malignant Lymphomas and Hodgkin's Disease: Experimental and Therapeutic Advances. Boston: Martinus Nijhoff Publishing, 1985, issue VI. 1.:281‐292. [245]
Stanf. K7, S8 {published and unpublished data}
    1. Kaplan H.S, Rosenberg S.A, Bissinger P.A. Current status of clinical trials: Stanford experience, 1962‐1972. Natl Cancer Inst Monogr 1973;36:363‐371. [8791] - PubMed
Stanf. S1 {published and unpublished data}
    1. Hoppe R.T, Coleman C.N, Cox R.S, Rosenberg S.A, Kaplan H.S. The management of stage I‐‐II Hodgkin's disease with irradiation alone or combined modality therapy: the Stanford experience. Blood 1982;59(3):455‐465. [92] - PubMed
    1. Rosenberg S.A, Kaplan H.S. The evolution and summary results of the Stanford randomized clinical trials of the management of Hodgkin's disease: 1962‐1984. Int J Radiat Oncol Biol Phys 1985;11(1):5‐22. [71] - PubMed
Stanf.H2‐H6, K1, R1 {published and unpublished data}
    1. Hoppe R.T, Coleman C.N, Cox R.S, Rosenberg S.A, Kaplan H.S. The management of stage I‐‐II Hodgkin's disease with irradiation alone or combined modality therapy: the Stanford experience. Blood 1982;59(3):455‐465. [92] - PubMed
    1. Hoppe R.T, Horning S.J, Hancock S.L, Rosenberg S.A. Current Stanford clinical trials for Hodgkin's disease. Recent Results Cancer Res 1989;117:182‐190. [205] - PubMed
    1. Hoppe R.T, Horning S.J, Rosenberg S.A. The concept, evolution and preliminary results of the current Stanford clinical trials for Hodgkin's disease. Cancer Surv 1985;4(2):459‐475. [3] - PubMed
    1. Kaplan H.S, Rosenberg S.A, Bissinger P.A. Current status of clinical trials: Stanford experience, 1962‐1972. Natl Cancer Inst Monogr 1973;36:363‐371. [8791] - PubMed
    1. Moore M.R, Bull J.M, Jones S.E, Rosenberg S.A, Kaplan H.S. Sequential radiotherapy and chemotherapy in the treatment of Hodgkin's disease. A progress report. Ann Intern Med 1972;77(1):1‐9. [8889] - PubMed

References to studies excluded from this review

BNLI, IF vs. EF {published data only}
    1. Haybittle J.L, Hayhoe F.G, Easterling M.J, Jelliffe A.M, Bennett M.H, Vaughan Hudson G, Vaughan Hudson B, MacLennan K.A. Review of British National Lymphoma Investigation studies of Hodgkin's disease and development of prognostic index. Lancet 1985;1(8435):967‐972. [172] - PubMed
    1. Hoskin P.J, Smith P, Linch D.C. Late morbidity and survival in early stage Hodgkin's disease treated with involved field or wide field radiotherapy alone.. Ann Oncol. 2002; Vol. 13 supp.2.
BNLI, RT vs. CRT {published data only}
    1. Strickland P. Radiotherapy or chemotherapy as the initial treatment for stage IIIA Hodgkin's disease (Report no 13). Clin.Radiol. 1981;32(5):527‐530. [43] - PubMed
BNLI, RT vs. CT {published data only}
    1. Haybittle J.L, Hayhoe F.G, Easterling M.J, Jelliffe A.M, Bennett M.H, Vaughan Hudson G, Vaughan Hudson B, MacLennan K.A. Review of British National Lymphoma Investigation studies of Hodgkin's disease and development of prognostic index. Lancet 1985;1(8435):967‐972. [172] - PubMed
    1. Jelliffe A.M. Initial treatment of stage IIIA Hodgkin's disease. Comparison of radiotherapy with combined chemotherapy. British National Lymphoma Investigation. Lancet 1976;2(7993):991‐995. [38] - PubMed
    1. Strickland P. Radiotherapy or chemotherapy as the initial treatment for stage IIIA Hodgkin's disease (Report no 13). Clin.Radiol. 1981;32(5):527‐530. [43] - PubMed
Can‐Am RHDG {published data only}
    1. Cornbleet M.A, Vitolo U, Ultmann J.E, Golomb H.M, Oleske D, Griem M.L, Ferguson D.J, Miller J.B. Pathologic stages IA and IIA Hodgkin's disease: results of treatment with radiotherapy alone (1968‐1980). J.Clin.Oncol. 1985;3(6):758‐768. [6761] - PubMed
    1. Fuller L.M, Hutchison G.B. Collaborative clinical trial for stage I and II Hodgkin's disease: significance of mediastinal and nonmediastinal disease in laparotomy‐ and non‐laparotomy‐staged patients. Cancer Treat.Rep. 1982;66(4):775‐787. [247] - PubMed
    1. Hagemeister F.B, Fuller L.M, Sullivan J.A, North L, Velasquez W, Conrad F.G, McLaughlin P, Butler J.J, Shullenberger C.C. Treatment of stage I and II mediastinal Hodgkin disease. A comparison of involved fields, extended fields, and involved fields followed by MOPP in patients staged by laparotomy. Radiology 1981;141(3):783‐789. [240] - PubMed
    1. Hagemeister F.B, Fuller L.M, Velasquez W.S, Sullivan J.A, North L, Butler J.J, Johnston D.A, Shullenberger C.C. Stage I and II Hodgkin's disease: involved‐field radiotherapy versus extended‐field radiotherapy versus involved‐field radiotherapy followed by six cycles of MOPP. Cancer Treat.Rep. 1982;66(4):789‐798. [231] - PubMed
    1. Hutchison G.B. Progress Report. Hodgkin's Clinical Trial, 1972. Natl Cancer Inst Monogr 1973;36:387‐393. - PubMed
CCG, #521 {published data only}
    1. Hutchinson R.J, Fryer C.J, Davis P.C, Nachman J, Krailo M.D, O'Brien R.T, Collins R.D, Whalen T, Reardon D, Trigg M.E, Gilchrist G.S. MOPP or radiation in addition to ABVD in the treatment of pathologically staged advanced Hodgkin's disease in children: results of the Children's Cancer Group Phase III Trial. J.Clin.Oncol. 1998;16(3):897‐906. [139] - PubMed
CCG, #5942 {published data only}
    1. Nachman J.B, Sposto R, Herzog P, Gilchrist G.S, Wolden S.L, Thomson J, Kadin M.E, Pattengale P, Davis P.C, Hutchinson R.J, White K. Randomized Comparison of Low‐Dose Involved‐Field Radiotherapy and No Radiotherapy for Children With Hodgkin's Disease Who Achieve a Complete Response to Chemotherapy. J.Clin.Oncol. 2002;20(18):3765‐3771. [276] - PubMed
Chicago, RT vs. CRT {published data only}
    1. Desser R.K, Golomb H.M, Ultmann J.E, Ferguson D.J, Moran E.M, Griem M.L, et al. Prognostic classification of Hodgkin disease in pathologic stage III, based on anatomic considerations. Blood 1977;49(6):883‐893. - PubMed
ECOG, 2475 {published data only (unpublished sought but not used)}
    1. Specht L, Gray R.G, Clarke M.J, Peto R. Influence of more extensive radiotherapy and adjuvant chemotherapy on long‐term outcome of early‐stage Hodgkin's disease: a meta‐analysis of 23 randomized trials involving 3,888 patients. International Hodgkin's Disease Collaborative Group. J.Clin.Oncol. 1998;16(3):830‐843. [187] - PubMed
ECOG, EST 1476 {published data only}
    1. Glick J, Tsiatis A, Prosnitz L, Rubin P, Bennett J. Improved survival with sequential Bleo‐MOPP followed by ABVD for advanced Hodgkin's disease (HD).. Proc. of Asco 1984;3:237, abst. C‐926.
    1. Glick J.H, Barnes J.M, Bakemeier R.F, Prosnitz L.R, Bennett J.M, Neiman R.S, Costello W, Orlow E.L. Treatment of advanced Hodgkin's disease: 10‐year experience in the Eastern Cooperative Oncology Group. Cancer Treat Rep 1982;66(4):855‐870. - PubMed
    1. Glick J.H, Tsiatis A. MOPP/ABVD chemotherapy for advanced Hodgkin's disease. Ann.Intern.Med. 1986;104(6):876‐878. [220] - PubMed
ECOG, EST 1481 {published data only}
    1. Glick J, Tsiatis A, Chen M, Rassiga A, Mann R, O'Connell M. Improved survival with MOPP‐ABVD compared to BCVPP +/‐ radiotherapy (RT) for advanced Hodgkin's disease (HD): 6‐year ECOG results (meeting abstract). Blood. 1990; Vol. 76, issue 10, Suppl 1):351a.
    1. Glick J, Tsiatis A, Chen M, Rassiga A, Mann R, O'Connell M. A randomized ECOG trialof alternating MOPP‐ABVD vs. BCVPP vs. BCVPP plus radiothearpy (RT) for advanced Hodgkin's disease (HD).. Proc. of ASCO. 1988; Vol. 7:223, abst. 863.
    1. Glick J.H, Tsiatis A. MOPP/ABVD chemotherapy for advanced Hodgkin's disease. Ann.Intern.Med. 1986;104(6):876‐878. [220] - PubMed
GEMH, H7701 {published data only}
    1. Andrieu J.M, Coscas Y, Cramer P, Julien C, Weil M, Tricot G. Chemotherapy plus radiotherapy in Clinical Stage IA to IIIB Hodgkin's disease. Results of the H 77 trial (1977‐1980). Experimental and Therapeutic Advances. Boston, MA, Martinus Nijhoff. 1985:353‐361. [271]
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GEMH, H9 69 {published data only}
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IHDCS (POG) {published data only}
    1. Gehan E.A, Sullivan M.P, Fuller L.M, Johnston J, Kennedy P, Fryer C, et al. The Intergroup Hodgkin's disease in children. A study of stages I and II. Cancer 1990;65:1429‐1437. - PubMed
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Lygra III {published data only (unpublished sought but not used)}
    1. Nordentoft AM, Pedersen‐Bjergaard J, Brincker H, et al. A national clinical study by the Danish Hodgkin study group, LYGRA. Scand J Haematol 1980;24:321‐334. - PubMed
Lyon, LMS 80a {published data only}
    1. Assouline D, Adeleine P, Jaubert J, Gastaud J.A, Carcassone Y, Blanc M, Martin C, Peaud P.Y, Archimbaud E, Coiffier B, Viala J.J, FiŠre D. Advanced Stages Hodgkin's Disease (HD): Long Term Results of the LMS 80 Protocol. Proceedings of ASCO. 1993; Vol. 12:381. [178]
Lyon, LMS 80b {published data only}
    1. Assouline D, Adeleine P, Jaubert J, Gastaud J.A, Carcassone Y, Blanc M, Martin C, Peaud P.Y, Archimbaud E, Coiffier B, Viala J.J, FiŠre D. Advanced Stages Hodgkin's Disease (HD): Long Term Results of the LMS 80 Protocol. Proceedings of ASCO. 1993; Vol. 12:381. [178]
Mexico Ho 8326 {published data only}
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Moscow {published data only}
    1. Blokhina N.G, Aliev B.M, Kruglova G.V, Kaverzneva M.M, Vasygova N.F. [Treatment of patients with lymphogranulomatosis, stages I and II (preliminary results of a randomized study‐‐radiation and complex therapy)]. Vestn Akad Med Nauk SSSR 1985, (1):45‐49. [6850] - PubMed
NCI, CT vs. CRT {published data only}
    1. Longo D.L, DeVita V.T, Jr. The use of combination chemotherapy in the treatment of early stage Hodgkin's disease. Important Adv Oncol 1992:155‐165. - PubMed
    1. O'Dwyer P.J, Wiernik P.H, Stewart M.B, Slawson R.G. Treatment of Early Stage Hodgkin's Disease: A Randomized Trial of Radiotherapy Plus Chemotherapy Versus Chemotherapy Alone. Proceedings of the Second International Conference on Malignant Lymphomas, Lugano, Switzerland, June 13‐16, 1984, Malignant Lymphomas and Hodgkin's Disease: Experimental and Therapeutic Advances. Boston: Martinus Nijhoff Publishing, 1985, issue VI. 6.:329‐336. [246]
NCI, RT vs. CRT {published data only}
    1. Dutcher J.P, Wiernik P. Combined modality treatment of Hodgkin's disease confined to lymph nodes. Results 14 years later. In: Cavalli F, Bonadonna G, Rozencweig M editor(s). Malignant Lymphomas and Hodgkin's Disease: Experimental and Therapeutic Advances. Boston: Martinus Nijhoff, 1985:317‐327. [272]
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NCI, RT vs. CT {published data only}
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POG, #8625 {published data only}
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POG, #8725 {published data only}
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    1. Weiner M. A, Leventhal B, Brecher M.L, Marcus R.B, Cantor A, Gieser P.W, Ternberg J.L, Behm F.G, Wharam M.D, Jr, Chauvenet A.R. Randomized study of intensive MOPP‐ABVD with or without Low‐Dose Total‐Nodal Radiation Therapy in Hodgkin's Disease in Pediatric Patients: a Pediatic Oncology Group Study. J Clin Oncol 1997;15(8):2769‐2779. [266] - PubMed
Roswell Park {published data only}
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    1. Gomez G.A, Steinbrenner L.S, Han T, Henderson E.S. Stage IIIA Hodgkin's disease (HD). Results of treatment at 15 years.. Proceedings of ASCO. 1988; Vol. 7:236, abstr. 912.
St. Bartholomew's {published data only}
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SWOG #7518 {published data only}
    1. Grozea P.N, Depersio E.J, Coltman C.A, Jr, Fabian C.J, Morrison F.S, Dixon D.O, Jones S.E. Chemotherapy alone versus combined modality therapy for stage III Hodgkin's disease: A five‐year follow‐up of a Southwest Oncology Group study (SWOG‐7518) USA. Dev Oncol 1985;32:345‐351.
    1. Jones S.E, Coltman C.A, Jr, Grozea P.N, DePersio E.J, Dixon D.O. Conclusions from clinical trials of the Southwest Oncology Group. Cancer Treat Rep 1982;66(4):847‐853. [174] - PubMed
SWOG #774/775 {published data only}
    1. Gehan E.A, Sullivan M.P, Fuller L.M, Johnston J, Kennedy P, Fryer C, Gilchrist G.S, Hays D.M, Hanson W, Heller R. The intergroup Hodgkin's disease in children. A study of stages I and II. Cancer 1990;65(6):1429‐1437. [191] - PubMed
    1. Toland D.M, Coltman C.A, Moon T.E. Second malignancies complicating Hodgkin's disease: The Southwest Oncology Group experience. Cancer Clinical Trials 1978:27‐33.
SWOG #7808 {published data only}
    1. Fabian C.J, Mansfield C.M, Dahlberg S, Jones S.E, Miller T.P, Slyck E, Grozea P.N, Morrison F.S, Coltman C.A, Jr, Fisher R.I. Low‐dose involved field radiation after chemotherapy in advanced Hodgkin disease. A Southwest Oncology Group randomized study. Ann.Intern.Med. 1994;120(11):903‐912. [202] - PubMed
SWOG #781 {published data only}
    1. Jones S.E, Coltman C.A, Jr, Grozea P.N, DePersio E.J, Dixon D.O. Conclusions from clinical trials of the Southwest Oncology Group. Cancer Treat.Rep. 1982;66(4):847‐853. [174] - PubMed
SWOG #9133 {published data only}
    1. Press O.W, LeBlanc M, Lichter A.S, Grogan T.M, Unger J.M, Wasserman T.H, Gaynor E.R, Peterson B.A, Miller T.P, Fisher R.I. Phase III randomized intergroup trial of subtotal lymphoid irradiation versus doxorubicin, vinblastine, and subtotal lymphoid irradiation for stage IA to IIA Hodgkin's disease. J.Clin.Oncol. 2001;19(22):4238‐4244. [201] - PubMed
Western CSG #135 {published data only}
    1. Loeffler M, Brosteanu O, Hasenclever D, Sextro M, Assouline D, Bartolucci A.A, Cassileth P.A, Crowther D, Diehl V, Fisher R.I, Hoppe R.T, Jacobs P, Pater J.L, Pavlovsky S, Thompson E, Wiernik P. Meta‐analysis of chemotherapy versus combined modality treatment trials in Hodgkin's disease. International Database on Hodgkin's Disease Overview Study Group. J Clin Oncol 1998;16(3):818‐829. [269] - PubMed

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