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Sandra J Horning - One of the best experts on this subject based on the ideXlab platform.

  • second cancers after treatment with stanford v regimen in eastern cooperative oncology group ecog pilot study e1492 at a median follow up of 17 years
    Blood, 2012
    Co-Authors: Ranjana H Advani, Nancy L. Bartlett, Richard T Hoppe, John M Bennett, Donna Neuberg, Peter A Cassileth, Brad S Kahl, Sandra J Horning
    Abstract:

    Abstract 4779 Purpose: The Stanford V regimen is a combined modality approach for treatment of Hodgkin lymphoma (HL). E1492, an ECOG pilot study, consisted of 12 weeks of Stanford V chemotherapy followed by 36 Gy radiation therapy (RT) to sites > 5 cm or macroscropic Splenic Disease at diagnosis. Efficacy results were reported previously (Horning et al. J Clin Onc 18, 2000). The study now has a median follow up of 17 years and patients have been followed for overall survival (OS) and development of second cancers. Methods: 47 eligible patients with stage bulky mediastinal (mass > one third of the maximum intrathoracic diameter) stage I-II or stage III-IV HL were enrolled between March 1992 and February 1995. Patients were followed every 3 months during the first year off therapy, every 6 months during years 2–5 and annually thereafter. The ECOG database was reviewed for OS and reported second cancers. Patient characteristics at baseline, type of second cancer and time to development of second cancer were assessed. RT summary forms were reviewed for patients with second cancers. Results: 41 patients were treated with combined modality therapy and 6 with chemotherapy alone. The median age was 32 years (range 20–56 years). The 5 and 10 year OS are 96%, and 89% respectively. Seven second cancers were reported, as shown in the Table. The cumulative incidence for second cancers accounting for death as a competing risk is 0.02 (95% CI, 0–0.06) at 5 years, 0.07 (95% CI, 0–0.14) at 10 years, and 0.15 (95% CI, 0.04–0.27) at 15 years. Complete details of the exact location, histologic subtype and subsequent management of second cancers were not available for review. Five of the 7 cancers [2 skin, 1 prostate, 2 acute myeloid leukemia (AML)] were not radiation-related. One patient developed AML after primary therapy as reported in the initial publication. A second patient developed AML 5 years after salvage therapy followed by autologous stem cell transplant for relapsed HL. It is likely the 2 cases of breast cancer were treatment related. Conclusion: Within the caveats of a retrospective analysis from a small cooperative group phase 2 trial, the mature 10 year OS of 89% and low frequency of secondary cancers are encouraging in comparison to historic treatment with combined modality treatment. Longer follow up of other Stanford V regimen data sets (i.e. United Kingdom National Cancer Research Institute Lymphoma Group Study ISRCTN 64141244 and the Eastern Cooperative Oncology Group E2496) are required to confirm these findings. Disclosures: No relevant conflicts of interest to declare.

  • efficacy and late effects of stanford v chemotherapy and radiotherapy in untreated hodgkin s Disease mature data in early and advanced stage patients
    Blood, 2004
    Co-Authors: Sandra J Horning, Ranjana H Advani, Richard T Hoppe, David Baer, Joseph Mason, Roger A Warnke, Saul A Rosenberg
    Abstract:

    From 5/89 to 5/01, 256 patients (pts) with classical Hodgkin’s Disease were treated on prospective trials with the weekly Stanford V (doxorubicin, vinblastine, mustard, vincristine, bleomycin, etoposide, prednisone) regimen +/− radiotherapy (RT). Pts with non-bulky stage I-IIA Disease received 8 weeks Stanford V + 30 Gy involved field RT (G4 protocol, n=87) at Stanford (n=52) or Northern California Kaiser Permanente (n=35). Pts with bulky stage II (mediastinal mass > 1/3 intrathoracic diameter) or III,IV Disease received 12 weeks Stanford V + 36 Gy to sites >=5 cm or macroscopic Splenic Disease (G2,3 protocol, n =169) at Stanford University. Bulky mediastinal pts received mediastinal, hilar and bilateral supraclavicular RT but no axillary or high neck RT to sites =4} with advanced stage Disease, 16 (67%) were successfully treated with second-line therapy. Eleven pts have died: 6 from Hodgkin’s Disease and 1 each from suicide, complications of second-line transplantation, influenza, lung cancer, and unknown cause. No cases of secondary myelodysplasia/leukemia or non-Hodgkin’s lymphoma have occurred. Second cancers included 1 prostate (no pelvic RT), 1 colon ( no abdominal RT but TBI used with second-line transplant), 1 lung (no RT) and 2 breast (1 with DCIS after mediastinal RT, 1 after axillary RT for >10 cm mass). To date, 72 post-treament conceptions (excluding pre-treament semen or embryo cryopreservation) were recorded with 65 live births (+ 4 current pregnancies) among 34 men and 30 women. In our hands, the Stanford V + RT regimen was effective with modest toxicity and 25% pts conceived post-treatment. An international score >=4 was the major adverse prognostic factor; the majority of relapses were successfully treated secondarily. These data support definitive testing of this treatment program as in the ongoing E2496 Intergroup Study for bulky and advanced stage Disease. Efficacy and Late Effects

  • stanford v and radiotherapy for locally extensive and advanced hodgkin s Disease mature results of a prospective clinical trial
    Journal of Clinical Oncology, 2002
    Co-Authors: Sandra J Horning, Nancy L. Bartlett, Richard T Hoppe, Sheila Breslin, William B Brown, Saul A Rosenberg
    Abstract:

    PURPOSE: To provide more mature data on the efficacy and complications of a brief, dose-intense chemotherapy regimen plus radiation therapy (RT) to bulky Disease sites for locally extensive and advanced-stage Hodgkin’s Disease. PATIENTS AND METHODS: One hundred forty-two patients with stage III or IV or locally extensive mediastinal stage I or II Hodgkin’s Disease received Stanford V chemotherapy for 12 weeks followed by 36-Gy RT to initial sites of bulky (≥ 5 cm) or macroscopic Splenic Disease. Freedom from progression (FFP), overall survival (OS), and freedom from second relapse (FF2R) were determined using life-table estimates. Outcomes were analyzed according to the international prognostic score. Late effects of treatment were recorded in follow-up. RESULTS: With a median follow-up of 5.4 years, the 5-year FFP was 89% and the OS was 96%. No patient progressed during treatment, and there were no treatment-related deaths. FFP was significantly superior among patients with a prognostic score of 0 to 2 c...

  • assessment of the stanford v regimen and consolidative radiotherapy for bulky and advanced hodgkin s Disease eastern cooperative oncology group pilot study e1492
    Journal of Clinical Oncology, 2000
    Co-Authors: Sandra J Horning, Nancy L. Bartlett, Richard T Hoppe, Jovanne Williams, John M Bennett, Donna Neuberg, Peter A Cassileth
    Abstract:

    PURPOSE: This study was performed, in a multi-institutional setting, to evaluate the efficacy and feasibility of the Stanford V chemotherapy regimen plus radiotherapy to bulky Hodgkin’s Disease sites. PATIENTS AND METHODS: A two-stage design was implemented in a phase II study involving 47 patients with bulky mediastinal stage I/II or stage III/IV Hodgkin’s Disease. Twelve weeks of the Stanford V chemotherapy regimen were given with consolidative radiotherapy (36 Gy) to lymph nodes ≥ 5 cm and/or macroscopic Splenic Disease. Treatment was administered in one of five institutions participating in the Eastern Cooperative Oncology Group. RESULTS: With a median follow-up of 4.8 years, 45 patients are alive and 40 have been continuously Disease-free. The estimated freedom from progression was 87% at 2 years and 85% at 5 years. Overall survival was 96% at 2 and 5 years. There was one death from Hodgkin’s Disease and one death from an M5 acute leukemia. Six of seven relapsed patients received high-dose therapy an...

Peter A Cassileth - One of the best experts on this subject based on the ideXlab platform.

  • second cancers after treatment with stanford v regimen in eastern cooperative oncology group ecog pilot study e1492 at a median follow up of 17 years
    Blood, 2012
    Co-Authors: Ranjana H Advani, Nancy L. Bartlett, Richard T Hoppe, John M Bennett, Donna Neuberg, Peter A Cassileth, Brad S Kahl, Sandra J Horning
    Abstract:

    Abstract 4779 Purpose: The Stanford V regimen is a combined modality approach for treatment of Hodgkin lymphoma (HL). E1492, an ECOG pilot study, consisted of 12 weeks of Stanford V chemotherapy followed by 36 Gy radiation therapy (RT) to sites > 5 cm or macroscropic Splenic Disease at diagnosis. Efficacy results were reported previously (Horning et al. J Clin Onc 18, 2000). The study now has a median follow up of 17 years and patients have been followed for overall survival (OS) and development of second cancers. Methods: 47 eligible patients with stage bulky mediastinal (mass > one third of the maximum intrathoracic diameter) stage I-II or stage III-IV HL were enrolled between March 1992 and February 1995. Patients were followed every 3 months during the first year off therapy, every 6 months during years 2–5 and annually thereafter. The ECOG database was reviewed for OS and reported second cancers. Patient characteristics at baseline, type of second cancer and time to development of second cancer were assessed. RT summary forms were reviewed for patients with second cancers. Results: 41 patients were treated with combined modality therapy and 6 with chemotherapy alone. The median age was 32 years (range 20–56 years). The 5 and 10 year OS are 96%, and 89% respectively. Seven second cancers were reported, as shown in the Table. The cumulative incidence for second cancers accounting for death as a competing risk is 0.02 (95% CI, 0–0.06) at 5 years, 0.07 (95% CI, 0–0.14) at 10 years, and 0.15 (95% CI, 0.04–0.27) at 15 years. Complete details of the exact location, histologic subtype and subsequent management of second cancers were not available for review. Five of the 7 cancers [2 skin, 1 prostate, 2 acute myeloid leukemia (AML)] were not radiation-related. One patient developed AML after primary therapy as reported in the initial publication. A second patient developed AML 5 years after salvage therapy followed by autologous stem cell transplant for relapsed HL. It is likely the 2 cases of breast cancer were treatment related. Conclusion: Within the caveats of a retrospective analysis from a small cooperative group phase 2 trial, the mature 10 year OS of 89% and low frequency of secondary cancers are encouraging in comparison to historic treatment with combined modality treatment. Longer follow up of other Stanford V regimen data sets (i.e. United Kingdom National Cancer Research Institute Lymphoma Group Study ISRCTN 64141244 and the Eastern Cooperative Oncology Group E2496) are required to confirm these findings. Disclosures: No relevant conflicts of interest to declare.

  • assessment of the stanford v regimen and consolidative radiotherapy for bulky and advanced hodgkin s Disease eastern cooperative oncology group pilot study e1492
    Journal of Clinical Oncology, 2000
    Co-Authors: Sandra J Horning, Nancy L. Bartlett, Richard T Hoppe, Jovanne Williams, John M Bennett, Donna Neuberg, Peter A Cassileth
    Abstract:

    PURPOSE: This study was performed, in a multi-institutional setting, to evaluate the efficacy and feasibility of the Stanford V chemotherapy regimen plus radiotherapy to bulky Hodgkin’s Disease sites. PATIENTS AND METHODS: A two-stage design was implemented in a phase II study involving 47 patients with bulky mediastinal stage I/II or stage III/IV Hodgkin’s Disease. Twelve weeks of the Stanford V chemotherapy regimen were given with consolidative radiotherapy (36 Gy) to lymph nodes ≥ 5 cm and/or macroscopic Splenic Disease. Treatment was administered in one of five institutions participating in the Eastern Cooperative Oncology Group. RESULTS: With a median follow-up of 4.8 years, 45 patients are alive and 40 have been continuously Disease-free. The estimated freedom from progression was 87% at 2 years and 85% at 5 years. Overall survival was 96% at 2 and 5 years. There was one death from Hodgkin’s Disease and one death from an M5 acute leukemia. Six of seven relapsed patients received high-dose therapy an...

Nancy L. Bartlett - One of the best experts on this subject based on the ideXlab platform.

  • second cancers after treatment with stanford v regimen in eastern cooperative oncology group ecog pilot study e1492 at a median follow up of 17 years
    Blood, 2012
    Co-Authors: Ranjana H Advani, Nancy L. Bartlett, Richard T Hoppe, John M Bennett, Donna Neuberg, Peter A Cassileth, Brad S Kahl, Sandra J Horning
    Abstract:

    Abstract 4779 Purpose: The Stanford V regimen is a combined modality approach for treatment of Hodgkin lymphoma (HL). E1492, an ECOG pilot study, consisted of 12 weeks of Stanford V chemotherapy followed by 36 Gy radiation therapy (RT) to sites > 5 cm or macroscropic Splenic Disease at diagnosis. Efficacy results were reported previously (Horning et al. J Clin Onc 18, 2000). The study now has a median follow up of 17 years and patients have been followed for overall survival (OS) and development of second cancers. Methods: 47 eligible patients with stage bulky mediastinal (mass > one third of the maximum intrathoracic diameter) stage I-II or stage III-IV HL were enrolled between March 1992 and February 1995. Patients were followed every 3 months during the first year off therapy, every 6 months during years 2–5 and annually thereafter. The ECOG database was reviewed for OS and reported second cancers. Patient characteristics at baseline, type of second cancer and time to development of second cancer were assessed. RT summary forms were reviewed for patients with second cancers. Results: 41 patients were treated with combined modality therapy and 6 with chemotherapy alone. The median age was 32 years (range 20–56 years). The 5 and 10 year OS are 96%, and 89% respectively. Seven second cancers were reported, as shown in the Table. The cumulative incidence for second cancers accounting for death as a competing risk is 0.02 (95% CI, 0–0.06) at 5 years, 0.07 (95% CI, 0–0.14) at 10 years, and 0.15 (95% CI, 0.04–0.27) at 15 years. Complete details of the exact location, histologic subtype and subsequent management of second cancers were not available for review. Five of the 7 cancers [2 skin, 1 prostate, 2 acute myeloid leukemia (AML)] were not radiation-related. One patient developed AML after primary therapy as reported in the initial publication. A second patient developed AML 5 years after salvage therapy followed by autologous stem cell transplant for relapsed HL. It is likely the 2 cases of breast cancer were treatment related. Conclusion: Within the caveats of a retrospective analysis from a small cooperative group phase 2 trial, the mature 10 year OS of 89% and low frequency of secondary cancers are encouraging in comparison to historic treatment with combined modality treatment. Longer follow up of other Stanford V regimen data sets (i.e. United Kingdom National Cancer Research Institute Lymphoma Group Study ISRCTN 64141244 and the Eastern Cooperative Oncology Group E2496) are required to confirm these findings. Disclosures: No relevant conflicts of interest to declare.

  • a randomized phase iii trial of abvd vs stanford v radiation therapy in locally extensive and advanced stage hodgkin s lymphoma an intergroup study coordinated by the eastern cooperatve oncology group e2496
    Blood, 2010
    Co-Authors: Leo I Gordon, Nancy L. Bartlett, Joseph M. Connors, Bruce D. Cheson, Richard I Fisher, Randy D Gascoyne, Henry N Wagner, Patrick J Stiff, Fanxing Hong, Mary K. Gospodarowicz
    Abstract:

    Abstract 415 Background: The ability to cure patients (pts) with advanced Hodgkin9s Lymphoma (HL) with combination chemotherapy (CC) (MOPP and variants, ABVD and variants) represented a major milestone in oncology research, and CC became a paradigm for other malignancies. Further, the rationale for combined modality therapy (CMT) (radiation (RT) and CC) in HL evolved based on the high frequency of relapse in initially involved sites. As response rates and survival improved, newer treatments such as the combined modality Stanford V regimen were developed to shorten the duration of chemotherapy, add RT to sites of Disease and reduce toxicity while maintaining or improving the cure rate. Indeed, the Stanford V regimen was tested and validated in a Phase II co-operative group trial (E1492) (J Clin Oncol 2000; 18:972). In order to investigate this approach against “standard” therapy, we conducted a randomized Phase III Intergroup trial of ABVD vs. the Stanford V regimen for patients with locally extensive or advanced HL. Objectives: The trial was designed to detect a 33% reduction in the failure free survival (FFS) hazard rate with Stanford V compared with ABVD, which corresponds to a difference in five-year FFS of 64% vs. 74%. Method: Patients with locally extensive (defined as clinical Ann Arbor Stage I-IIA/B and bulky mediastinal Disease (BMD) (mass > 1/3 maximum intrathoracic diameter on standing postero-anterior chest x-ray or >/−10 cm on computerized tomography) or advanced (Ann Arbor Stage III or IV) HL were randomized to receive either ABVD × 6–8 cycles (C) (51% had 6 C, 35% had 8 C, 14% had 5cm or for macroscopic Splenic Disease). The log-rank test was used to compare FFS for all eligible patients stratified on extent of Disease (locally extensive vs. advanced), and number of International Prognostic Factor Project (IPFP) risk factors (0–2 vs. 3–7). An extended Cox model was also used to address non-proportional hazard between the two arms. Results: 854 pts enrolled from April, 1999 to June, 2006 and 812 were eligible for analysis. 404 pts were randomized to ABVD and 408 to Stanford V. Median age was 33 yrs in both arms (range 16–83). 53% were men and 47% women; 4% had Stage I, 31% had Stage II, 39% had Stage III and 25% had Stage IV Disease by Ann Arbor criteria. 35% of pts on ABVD and 35% on Stanford V had BMD. Three % of pts had nodular lymphocyte predominant HL, 77% of pts had nodular sclerosis HL, 14% had mixed cell HL. Age, stage, pathology and risk factors (0–2 vs. 3–7) were similar in both arms. In total, 65% were IPFP score 0–2 and 33% were 3–6. Response rate. There was no difference in response rates (RR) between the two arms (ABVD=72% CR+ CCR, 7.7% PR, 7.9% SD; Stanford V= 69 % CR +CCR, 7% PR and 10 % SD. 8% were not evaluable for response on ABVD and 9% on Stanford V. Toxicity was similar in both groups. The most frequent Grade 3 + 4 toxicity was neutropenia, and was similar between the 2 groups (76% Grade 3 + 4 in ABVD and 70% Grade 3+ 4 in Stanford V). Grade 5 toxicity was Conclusion: In the largest Phase III intergroup trial of HL in North America, there was no significant difference in RR, FFS, OS, and 5-year toxicity when ABVD (+ RT for BMD) is compared with Stanford V (+RT for nodal sites >5 cm and macroscopic Splenic Disease). There was more Grade 3 lymphopenia (p Disclosures: Friedberg:Genentech: Honoraria. Blum:Seattle Genetics: Research Funding; Novartis: Research Funding; Celgene: Research Funding. Horning:Genentech: Employment.

  • stanford v and radiotherapy for locally extensive and advanced hodgkin s Disease mature results of a prospective clinical trial
    Journal of Clinical Oncology, 2002
    Co-Authors: Sandra J Horning, Nancy L. Bartlett, Richard T Hoppe, Sheila Breslin, William B Brown, Saul A Rosenberg
    Abstract:

    PURPOSE: To provide more mature data on the efficacy and complications of a brief, dose-intense chemotherapy regimen plus radiation therapy (RT) to bulky Disease sites for locally extensive and advanced-stage Hodgkin’s Disease. PATIENTS AND METHODS: One hundred forty-two patients with stage III or IV or locally extensive mediastinal stage I or II Hodgkin’s Disease received Stanford V chemotherapy for 12 weeks followed by 36-Gy RT to initial sites of bulky (≥ 5 cm) or macroscopic Splenic Disease. Freedom from progression (FFP), overall survival (OS), and freedom from second relapse (FF2R) were determined using life-table estimates. Outcomes were analyzed according to the international prognostic score. Late effects of treatment were recorded in follow-up. RESULTS: With a median follow-up of 5.4 years, the 5-year FFP was 89% and the OS was 96%. No patient progressed during treatment, and there were no treatment-related deaths. FFP was significantly superior among patients with a prognostic score of 0 to 2 c...

  • assessment of the stanford v regimen and consolidative radiotherapy for bulky and advanced hodgkin s Disease eastern cooperative oncology group pilot study e1492
    Journal of Clinical Oncology, 2000
    Co-Authors: Sandra J Horning, Nancy L. Bartlett, Richard T Hoppe, Jovanne Williams, John M Bennett, Donna Neuberg, Peter A Cassileth
    Abstract:

    PURPOSE: This study was performed, in a multi-institutional setting, to evaluate the efficacy and feasibility of the Stanford V chemotherapy regimen plus radiotherapy to bulky Hodgkin’s Disease sites. PATIENTS AND METHODS: A two-stage design was implemented in a phase II study involving 47 patients with bulky mediastinal stage I/II or stage III/IV Hodgkin’s Disease. Twelve weeks of the Stanford V chemotherapy regimen were given with consolidative radiotherapy (36 Gy) to lymph nodes ≥ 5 cm and/or macroscopic Splenic Disease. Treatment was administered in one of five institutions participating in the Eastern Cooperative Oncology Group. RESULTS: With a median follow-up of 4.8 years, 45 patients are alive and 40 have been continuously Disease-free. The estimated freedom from progression was 87% at 2 years and 85% at 5 years. Overall survival was 96% at 2 and 5 years. There was one death from Hodgkin’s Disease and one death from an M5 acute leukemia. Six of seven relapsed patients received high-dose therapy an...

Richard T Hoppe - One of the best experts on this subject based on the ideXlab platform.

  • second cancers after treatment with stanford v regimen in eastern cooperative oncology group ecog pilot study e1492 at a median follow up of 17 years
    Blood, 2012
    Co-Authors: Ranjana H Advani, Nancy L. Bartlett, Richard T Hoppe, John M Bennett, Donna Neuberg, Peter A Cassileth, Brad S Kahl, Sandra J Horning
    Abstract:

    Abstract 4779 Purpose: The Stanford V regimen is a combined modality approach for treatment of Hodgkin lymphoma (HL). E1492, an ECOG pilot study, consisted of 12 weeks of Stanford V chemotherapy followed by 36 Gy radiation therapy (RT) to sites > 5 cm or macroscropic Splenic Disease at diagnosis. Efficacy results were reported previously (Horning et al. J Clin Onc 18, 2000). The study now has a median follow up of 17 years and patients have been followed for overall survival (OS) and development of second cancers. Methods: 47 eligible patients with stage bulky mediastinal (mass > one third of the maximum intrathoracic diameter) stage I-II or stage III-IV HL were enrolled between March 1992 and February 1995. Patients were followed every 3 months during the first year off therapy, every 6 months during years 2–5 and annually thereafter. The ECOG database was reviewed for OS and reported second cancers. Patient characteristics at baseline, type of second cancer and time to development of second cancer were assessed. RT summary forms were reviewed for patients with second cancers. Results: 41 patients were treated with combined modality therapy and 6 with chemotherapy alone. The median age was 32 years (range 20–56 years). The 5 and 10 year OS are 96%, and 89% respectively. Seven second cancers were reported, as shown in the Table. The cumulative incidence for second cancers accounting for death as a competing risk is 0.02 (95% CI, 0–0.06) at 5 years, 0.07 (95% CI, 0–0.14) at 10 years, and 0.15 (95% CI, 0.04–0.27) at 15 years. Complete details of the exact location, histologic subtype and subsequent management of second cancers were not available for review. Five of the 7 cancers [2 skin, 1 prostate, 2 acute myeloid leukemia (AML)] were not radiation-related. One patient developed AML after primary therapy as reported in the initial publication. A second patient developed AML 5 years after salvage therapy followed by autologous stem cell transplant for relapsed HL. It is likely the 2 cases of breast cancer were treatment related. Conclusion: Within the caveats of a retrospective analysis from a small cooperative group phase 2 trial, the mature 10 year OS of 89% and low frequency of secondary cancers are encouraging in comparison to historic treatment with combined modality treatment. Longer follow up of other Stanford V regimen data sets (i.e. United Kingdom National Cancer Research Institute Lymphoma Group Study ISRCTN 64141244 and the Eastern Cooperative Oncology Group E2496) are required to confirm these findings. Disclosures: No relevant conflicts of interest to declare.

  • efficacy and late effects of stanford v chemotherapy and radiotherapy in untreated hodgkin s Disease mature data in early and advanced stage patients
    Blood, 2004
    Co-Authors: Sandra J Horning, Ranjana H Advani, Richard T Hoppe, David Baer, Joseph Mason, Roger A Warnke, Saul A Rosenberg
    Abstract:

    From 5/89 to 5/01, 256 patients (pts) with classical Hodgkin’s Disease were treated on prospective trials with the weekly Stanford V (doxorubicin, vinblastine, mustard, vincristine, bleomycin, etoposide, prednisone) regimen +/− radiotherapy (RT). Pts with non-bulky stage I-IIA Disease received 8 weeks Stanford V + 30 Gy involved field RT (G4 protocol, n=87) at Stanford (n=52) or Northern California Kaiser Permanente (n=35). Pts with bulky stage II (mediastinal mass > 1/3 intrathoracic diameter) or III,IV Disease received 12 weeks Stanford V + 36 Gy to sites >=5 cm or macroscopic Splenic Disease (G2,3 protocol, n =169) at Stanford University. Bulky mediastinal pts received mediastinal, hilar and bilateral supraclavicular RT but no axillary or high neck RT to sites =4} with advanced stage Disease, 16 (67%) were successfully treated with second-line therapy. Eleven pts have died: 6 from Hodgkin’s Disease and 1 each from suicide, complications of second-line transplantation, influenza, lung cancer, and unknown cause. No cases of secondary myelodysplasia/leukemia or non-Hodgkin’s lymphoma have occurred. Second cancers included 1 prostate (no pelvic RT), 1 colon ( no abdominal RT but TBI used with second-line transplant), 1 lung (no RT) and 2 breast (1 with DCIS after mediastinal RT, 1 after axillary RT for >10 cm mass). To date, 72 post-treament conceptions (excluding pre-treament semen or embryo cryopreservation) were recorded with 65 live births (+ 4 current pregnancies) among 34 men and 30 women. In our hands, the Stanford V + RT regimen was effective with modest toxicity and 25% pts conceived post-treatment. An international score >=4 was the major adverse prognostic factor; the majority of relapses were successfully treated secondarily. These data support definitive testing of this treatment program as in the ongoing E2496 Intergroup Study for bulky and advanced stage Disease. Efficacy and Late Effects

  • stanford v and radiotherapy for locally extensive and advanced hodgkin s Disease mature results of a prospective clinical trial
    Journal of Clinical Oncology, 2002
    Co-Authors: Sandra J Horning, Nancy L. Bartlett, Richard T Hoppe, Sheila Breslin, William B Brown, Saul A Rosenberg
    Abstract:

    PURPOSE: To provide more mature data on the efficacy and complications of a brief, dose-intense chemotherapy regimen plus radiation therapy (RT) to bulky Disease sites for locally extensive and advanced-stage Hodgkin’s Disease. PATIENTS AND METHODS: One hundred forty-two patients with stage III or IV or locally extensive mediastinal stage I or II Hodgkin’s Disease received Stanford V chemotherapy for 12 weeks followed by 36-Gy RT to initial sites of bulky (≥ 5 cm) or macroscopic Splenic Disease. Freedom from progression (FFP), overall survival (OS), and freedom from second relapse (FF2R) were determined using life-table estimates. Outcomes were analyzed according to the international prognostic score. Late effects of treatment were recorded in follow-up. RESULTS: With a median follow-up of 5.4 years, the 5-year FFP was 89% and the OS was 96%. No patient progressed during treatment, and there were no treatment-related deaths. FFP was significantly superior among patients with a prognostic score of 0 to 2 c...

  • assessment of the stanford v regimen and consolidative radiotherapy for bulky and advanced hodgkin s Disease eastern cooperative oncology group pilot study e1492
    Journal of Clinical Oncology, 2000
    Co-Authors: Sandra J Horning, Nancy L. Bartlett, Richard T Hoppe, Jovanne Williams, John M Bennett, Donna Neuberg, Peter A Cassileth
    Abstract:

    PURPOSE: This study was performed, in a multi-institutional setting, to evaluate the efficacy and feasibility of the Stanford V chemotherapy regimen plus radiotherapy to bulky Hodgkin’s Disease sites. PATIENTS AND METHODS: A two-stage design was implemented in a phase II study involving 47 patients with bulky mediastinal stage I/II or stage III/IV Hodgkin’s Disease. Twelve weeks of the Stanford V chemotherapy regimen were given with consolidative radiotherapy (36 Gy) to lymph nodes ≥ 5 cm and/or macroscopic Splenic Disease. Treatment was administered in one of five institutions participating in the Eastern Cooperative Oncology Group. RESULTS: With a median follow-up of 4.8 years, 45 patients are alive and 40 have been continuously Disease-free. The estimated freedom from progression was 87% at 2 years and 85% at 5 years. Overall survival was 96% at 2 and 5 years. There was one death from Hodgkin’s Disease and one death from an M5 acute leukemia. Six of seven relapsed patients received high-dose therapy an...

Maria K Angelopoulou - One of the best experts on this subject based on the ideXlab platform.