Hodgkin's disease: results of treatment with combination chemotherapy

Combination chemotherapy, which consisted of nitrogen mustard, a vinca alkaloid, procarbazine, and prednisone, was given to 60 patients with disseminated or recurrent Hodgkin's disease. A complete remission of disease was observed in 41 patients, with a median duration of 35+ months. The longest continuing remission was 89 months, and 52% of patients who achieved a complete remission were alive five years from the start of treatment. In contrast, patients who only had a partial remission (11 patients), or failed to respond to therapy (8 patients) fared badly, with a less than 50% survival rate at one year. Response to drug therapy could not be predicted on the basis of sex, age or tumour histology, but patients who had previously received both radiotherapy and chemotherapy had a poor prognosis. Drug toxicity was substantial, but was considered acceptable in view of the clear benefit of treatment to most patients. Further improvement in the outlook of patients with advanced Hodgkin's disease is likely to result from modifications of current drug regimens, possibly combined with non-radical radiotherapy.