Key result
Clinical cardiac events occurred in 6% of patients receiving EBVD, 9% receiving ABVD, and 17% receiving MBVD (P < 0.001), indicating lower cardiac toxicity with epirubicin.
Why the study?
Does epirubicin or mitoxantrone compared to doxorubicin in combined therapy reduce late cardiac toxicity in patients with stage III and IV Hodgkin's disease?
Population
476 patients with Hodgkin's disease, stages III and IV. Key exclusion: received radiation therapy.
Comparison
EBVD or MBVD at standard doses vs ABVD at standard doses
Design
RCT, Randomly assigned
Follow-up
Median 11.5 years (range 7.5 - 14.8 years)
Authors
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Supports preferring EBVD in advanced Hodgkin lymphoma to minimize cardiac risk; confirms epirubicin's advantage and extends anthracycline selection data.
RCT (n=476)
randomly assigned
Does epirubicin or mitoxantrone compared to doxorubicin in combined therapy reduce late cardiac toxicity in patients with stage III and IV Hodgkin's disease?
Absolute Event Rate: 6% vs 9%
p-value: p=< 0.001
Epirubicin-based chemotherapy (EBVD) is associated with significantly lower late cardiac toxicity and better overall survival compared to doxorubicin (ABVD) or mitoxantrone (MBVD) in patients with advanced Hodgkin's disease.
Avilés et al. (2005) conducted an RCT in Hodgkin's disease (n=476). EBVD and MBVD vs. ABVD was evaluated on Clinical cardiac event (CCE) or abnormalities in equilibrium radionuclide angiocardiography (ERNA) and echocardiogram (p=< 0.001). Clinical cardiac events occurred in 6% of patients receiving EBVD, 9% receiving ABVD, and 17% receiving MBVD (P < 0.001), indicating lower cardiac toxicity with epirubicin.
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