Abstract
Fifty evaluable, previously untreated, adult patients with clinically staged (CS) early and advanced Hodgkin's disease were treated with chemotherapy alone, using various regimens. Their mean age was 31.9 years. Fifteen patients (30%) had CS I or II and 35 (70%) had CS III or IV Eighty‐eight per cent of patients had one or more of the B symptoms and 64% had an unfavorable histology. Complete remission (CR) was achieved in 43 out of 50 patients (86% with 95% confidence interval of 76% to 96%), partial remission in 3 (6%) and treatment failure in 4. Adjusted analysis, using all possible subset regression, showed that unfavorable histology, bulky disease and receiving a total dose‐intensity (TDI) ⩽ 0.80 were negatively associated with the likelihood of achieving CR. At a median follow‐up of 36 months (range, 6‐90), 84% of patients were alive and 82% were disease‐free. The overall median survival has not been reached, but the projected 5‐year survival probability was 79%. Time‐to‐relapse was also estimated for those who achieved initial CR. The estimated 5‐year relapse‐free survival was 87%. The Cox proportional hazards model predicted that unfavorable histology, bulky disease and TDI ⩽ 0.80 had an independent, adverse influence on survival. We conclude that the results of chemotherapy alone are encouraging and the rationale is practical and acceptable in those countries where the availability of radiotherapy units is limited.