The results of the Southwest Oncology Group studythe largest randomized trial of early-stage Hodgkin’s disease in the U.S. in the past two decadesappeared to affirm the wisdom of the increasingly common chemoradiation approach.

In the phase-3 trial, which omitted staging laparotomy, the 165 patients with Stage Ia to IIa supradiaphragmatic Hodgkin’s disease given chemotherapy plus subtotal lymphoid irradiation had a 94% estimated failure-free survival rate after three years, compared with 91% for the 161 patients given subtotal lymphoid irradiation alone. Chemotherapy consisted of three cycles of doxorubicin and vinblastine. Toxicity was described as minimal.

After a median follow-up of 3.3 years, 10 patients had relapsed or died in the chemoradiotherapy arm, compared with 34 in the radiotherapy-alone arm, Dr. Oliver W. Press of the Fred Hutchinson Cancer Research Center here and colleagues reported in the Nov. 15 Journal of Clinical Oncology. Overall, three chemoradiation patients and seven radiation-only patients died.

Instead of undergoing staging laparotomy, patients in the trial were staged clinically on the basis of tumor size and lymph-node involvement.

Because of the markedly superior results for the chemoradiation patients, the trial was stopped early after nine years, with only 80% of the planned accrual.