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Lymphoma - Hodgkin's; Hodgkin's lymphoma; Hodgkins disease; HD
Chemotherapy uses drugs to kill cancer cells. The drugs are called cytotoxic medications. Chemotherapy is referred to as body-wide, or systemic, therapy because the drugs travel throughout the entire body.
Cytotoxic drugs may be taken by mouth or given by injection. Treatment may be administered at a medical center, doctor's office, or even a patient's home. Some patients receiving chemotherapy may need to remain in the hospital for several days so the effects of the drug can be monitored.
Patients may receive 4 - 8 cycles of chemotherapy, depending on the stage. A cycle is usually 28 days and consists of several doses of drug administration followed by a period of rest.
The standard chemotherapy regimens for Hodgkinâ ' s disease are ABVD and Stanford V.
ABVD consists of a 4-drug combination:
Stanford V consists of a 7-drug combination:
BEACOPP (bleomycin, etoposide, Adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone) is a chemotherapy regimen reserved for high-risk patients. This regimen is proving to be extremely effective, particularly in advanced stages, with studies reporting remission rates of over 95% in patients with advanced Hodgkin's. However, this regimen also increases the risk for developing secondary cancers such as leukemia. Patients who are treated with BEACOPP should receive long-term follow-up care to monitor for side effects from this therapy.
Side effects and complications of any chemotherapeutic regimen are common, are more severe with higher doses, and increase over the course of treatment, though some trials suggest that toxicities can be reduced by administering the drugs for shorter duration without loss of cancer-killing effects.
Common Side Effects. Common side effects include the following:
These side effects are nearly always temporary. Most patients are able to continue with normal activities for all but perhaps 1 or 2 days a month.
Serious Side Effects. Serious side effects can also occur and may vary depending on the specific drugs used. They include:
In general, these serious late side effects are dependent on the cumulative drug dose and rate of administration.
Chemotherapy (usually ABVD) plus involved-field radiation, referred to as combined modality, is a common treatment approach for patients with more advanced-stage disease and for those who have early-stage bulky (large mass) disease. Chemotherapy with low-dose radiation is also used in children with excellent results, even for late stage cancer.
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