الفهرس 
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Abstract
Background and Objectives: The optimal treatment of early-stage
Hodgkin lymphoma has been controversial because of the success of
several approaches. Concerns regarding radiation toxicities and the
previously detected good response to chemotherapy have led some to
withhold radiation therapy (RT) for the treatment of stage I , II and IIIA
Hodgkin’s lymphoma. The aim of This study To determine whether
combined modality therapy (CMT) is superior to chemotherapy (CT) alone
in early stage Hodgkin’s lymphoma patients.
Patients and methods: This was a prospective clinical trial carried in Kasr
El Aini Oncology And Nuclear Medicine Centre (NEMROCK) . from
February 2007 to June 2011, untreated Hodgkin Lymphoma patients with
clinical stages (CSs) IA, IB, IIA, IIB, and IIIA were randomized to 4 cycles
of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) alone or 4
cycles of ABVD followed by radiation therapy (RT) (3600) cGy. Patients
were tested for pre-treatment sCD30 and IL13 levels. Response rate,
disease free survival and overall survival were estimated by the Kaplan-
Meier method, and Cox multivariable Regression model was used to
analyze trends.
Results: Of 60 patients randomized 30 receive RT after 4 cycles of ABVD;
the complete remission (CR) percentage was 83.3% and partial response,
16.7%. For ABVD alone, 73% achieved a CR; 23.3%, a partial response
(PR); and 3.3%, disease progression. At 30 months relapse rate,
progression free survival (PFS), and overall survival (OS) for ABVD _ RT
versus ABVD alone are 16.7% versus 28.4% , 83% versus 60% (P _ .004),
and 93.3% versus 90% (P _ .222), respectively (log-rank).
Conclusion: Additional radiotherapy improves response, prevents relapse
and increases RFS in patients receiving four cycles of ABVD hemotherapy.
Combined modality treatment (ABVD and consolidation radiotherapy) is
standard of care. A biological parameter such as serum sCD30 level could
be helpful in obtaining a more precise selection of patients suitable for
more intensive treatment.
Key Word: ABVD-BLEOMYCIN-VINBLASTINE-RT