Stanford V

This regimen was introduced in 1995 with an objective of improving cure rate and limiting toxicities. Table 73.6 describes the schedule dosing of this regimen. Essentially, it is similar to the MOPP/ABV hybrid regimen but adds modest doses of Etoposide. Radiation therapy is an integral component of this regimen with 36 Gy radiation given to sites of bulky disease more than 5 cm in diameter. An initial report, followed recently by more mature data, showed an FFS of 86% with a 95% OS after 6.9 years of follow-up.68'69 These numbers remained consistent in patients with bulky mediastinal disease.70 Secondary malignancies and infertility were reported to be less than 10%. This favorable toxicity profile, coupled with excellent efficacy, prompted interest in this regimen as a substitute for ABVD.71 However, a recent study from Italy showed an FFS inferiority for the Stanford regimen as compared to ABVD.72 This study compared three chemotherapy regimens: Stanford V, ABVD, and MOPP-EBV-CAD (MEC) (a combination regimen using mechlorethamine, CCNU, vindesine, alkeran, prednisone, epidoxoru-bicin, vincristine, procarbazine, vinblastine, and bleomycin). Although OS was not statically different, FFS, at 56 months follow-up, was 83% for ABVD, compared to 67% for Stanford V. However, an important point is that Stanford V is a combined modality regimen, with radiation therapy routinely given in up to

85% of the patients. The Italian trial used radiation therapy in only two-thirds of patients, and frequently at suboptimal dosages. Stanford V, with or without radiation therapy, is currently being compared to ABVD in advanced HL in an intergroup trial.71

Pregnancy Guide

Pregnancy Guide

A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.

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