[Physiological significance of prostaglandins].
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Biomedical subjects
Publications and source records attributed to J M Andrieu.
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From April 1972 to December 1976, 334 patients with Hodgkin's disease, CS IA-IIIB, were prospectively treated with combined chemotherapy and radiation. The 166 stages IA and II2A were clinically staged only; the 168 other patients were randomized to clinical or pathological staging. All patients received 3 or 6 cycles of MOPP followed by Mantle field with or without mediastinal irradiation and/or inverted Y or lumbo-aortic field according to initial stage, presentation and protocol. At completion of therapy, 317 patients were in complete remission. Twenty-six patients relapsed and 43 died including 5 with leukemia and 6 with infection. Overall 12-year survival and relapse-free rates are 86.6 +/- 3.08 per cent and 91.5 +/- 3.2 per cent respectively (IA: 95.3 and 95.3 per cent; IIA: 87.8 and 92.1 per cent; IIIA: 83.3 and 100 per cent; IB, IIB: 81.7 and 89.2 per cent; IIIB: 67.8 and 73.7 per cent). The randomized comparison between clinical staging plus 6 cycles of MOPP and laparotomy staging plus 3 cycles of MOPP in final stage II3+A, IB, IIB patients showed no significant 12-year survival differences (90.8 versus 85.6 per cent). With this combined modality treatment policy, high survival rates are obtained using only 3 cycles of MOPP and radiotherapy in CS IA, II2A and in PS II3+, IB, IIB. Laparotomy staging may be unnecessary if 6 cycles of MOPP are employed before irradiation in CS IIA, IB, IIB disease and if 3 cycles of MOPP are followed by irradiation in CSIA and II2A disease. Mediastinal irradiation can be avoided in patients with supradiaphragmatic disease without mediastinal involvement.
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224 patients with stage III and IV Hodgkin's disease (H.D.) have been treated by 6 monthly MOPP courses. 190 patients achieved remission and among them there were 109 complete remissions (C.R.) . All patients received vinblastin maintenance combined with "reinduction" courses of MOPP (68 patients) or irradiation (57 patients). At ten years, remission curves are "on plateau" at 72% for those patients who achieved C.R. at 48% for those who had partial remission, and for all patients the ten years survival rate is 53%. The parameters which influence C.R. achievement are age, fever, histology, but the best predictive parameter seems to be lymphogram: diffuse involvement and aspects of cystic storage pattern as seen in "non Hodgkin lymphoma" heralding an unfavorable prognosis. The lymphogram picture should thus be included as parameter of initial classification and treatment active in "non Hodgkin lymphoma" such as Vincristine - Cytoxan - Prednisone - Adriamicin should be tried in these high risk patients.