[Significance of procarbazine in the chemotherapy of Hodgkin's disease--a report of the Cooperative Therapy Study DAL-HD-85].

It was the objective of the DAL study HD-85 to examine the possibility of a reduction of chemotherapy, compared to the study HD-82 which had applied a combined treatment strategy resulting in a relapse rate of only 2.5% after 4 years, and a proportion of intercurrent deaths of 1.5%, in a total of 203 patients. Procarbazine was eliminated in the OPPA-therapy (OPA) and replaced by methotrexate in the COPP-cycles (COMP). Chemotherapy consisted in 2 cycles of OPA for stage I/IIA (group 1), 2 cycles of OPA and 2 cycles of COMP for stage IIB/IIIA (including IEA/IIEA) (group 2), and 2 cycles of OPA and 4 cycles of COMP for stage IIIB/IV (group 3). The subsequent radiotherapy was limited to the initially involved fields, the dosage of 35, 30 or 25 Gy depending on the extent of chemotherapy. Regions showing incomplete tumor regression after chemotherapy received another 5 Gy, in patients of groups 2 and 3. Between Jan. 1985 to Nov. 1986, 103 children with Hodgkin's disease from 42 participating hospitals were enrolled in this study. 98 patients were treated according to protocol (59 boys, 39 girls). A specific strategy for the selective indication of laparotomy and splenectomy was applied. With this strategy no laparotomy was performed in 39/98 patients (40%). 67 patients (68%) retained their spleen. 4 patients showed progression of the disease under chemotherapy, all others achieved remission. 16 patients relapsed before Dec. 31, 1987. So far no child of this study has died.(ABSTRACT TRUNCATED AT 250 WORDS)