A limited role for VEEP (vincristine, etoposide, epirubicin, prednisolone)chemotherapy in childhood Hodgkin's disease

Citation
Ag. Shankar et al., A limited role for VEEP (vincristine, etoposide, epirubicin, prednisolone)chemotherapy in childhood Hodgkin's disease, EUR J CANC, 34(13), 1998, pp. 2058-2063
Citations number
27
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
EUROPEAN JOURNAL OF CANCER
ISSN journal
0959-8049 → ACNP
Volume
34
Issue
13
Year of publication
1998
Pages
2058 - 2063
Database
ISI
SICI code
0959-8049(199812)34:13<2058:ALRFV(>2.0.ZU;2-#
Abstract
The VEEP regimen (vincristine, etoposide, epirubicin, prednisolone), with o r without involved field radiotherapy, has been shown to be an effective tr eatment in adult Hodgkin's disease. In an attempt to avoid the: late sequel ae of both alkylating agents and radiotherapy this regimen has been studied in a series of 54 children and young adults. Early analysis suggested that the relapse rate was higher with VEEP than with standard alkylating agent- based regimens. Sufficient follow-up has now been achieved to evaluate the likelihood of sustained remission following second-line treatment and there fore the overall long term survival with this treatment approach, The 5-yea r Overall Survival (OS) and 5-year Progression Free Survival (PFS) for pati ents with stage I-III disease was 93% and 82% respectively. However, the 5- year OS and PFS for stage IV patients was only 44% and 50%, respectively. O f 13 patients who were initial treatment failures on VEEP, 7 of whom had ad vanced disease, only 6 were salvaged with second-line therapy, 8 of 33 who attained a complete response (CR) relapsed and there were 2 relapses in tho se achieving a partial response (PR) (n=8). All those relapsing from CH/PR were salvaged by second-line alkylating agent chemotherapy +/- radiotherapy , +/- high dose chemotherapy. In conclusion, patients with stage I-IIIA, ne a-bulky disease, the moderately high relapse rate did not adversely affect the overall high cure rate, although VEEP failures were subjected to a high total treatment burden. VEEP alone is inadequate in patients with stage IV disease, bulky mediastinal disease in/or those with B symptoms in whom the re is a high primary failure rate and relatively poor results with second l ine therapy. (C) 1998 Elsevier Science Ltd. All rights reserved.