Treatment Regimen
The mStanford V regimen (Table 2s) consisted of chemotherapy for 12
consecutive weeks followed by involved-field radiation therapy (IFRT).
The chemotherapy was: prednisone 40mg/m2 orally divided bid every other
day for 10 weeks followed by a 2 week taper, doxorubicin 25
mg/m2 and vinblastine 6 mg/m2 on
weeks 1, 3, 5, 7, 9 and 11; cyclophosphamide 600 mg/m2on weeks 1, 5 and 9; vincristine 1.4 mg/m2 (maximum of
2mg) and bleomycin 5 UI/m2 on weeks 2, 4, 6, 8, 10 and
12 and etoposide 60 mg/m2 on days 1 and 2 of weeks 3,
7 and 11. The modification from the original StanfordV
regimen7, consisted of the substitution of
cyclophosphamide 600 mg/m2/dose, instead of
mechlorethamine
6mg/m2/dose. Radiation therapy (cobalt unit or linear
accelerator) was administered to all originally involved sites of
disease according to their response to chemotherapy at either 2000cGy to
the sites that achieved an anatomic complete remission (>
80% reduction of the sum of the perpendicular diameters or return to
normal size lymph nodes) or 2500cGy to the sites that did not achieved a
complete remission. Chemotherapy was held for 1 week if ANC was less
than 1000 and/or platelets less than 100,000 on the weeks that included
doxorubicin. All patients received pneumocystis jovenci prophylaxis with
trimethoprim/sulfamethoxazole. Some units were able to give filgrastim
to patients with prolonged neutropenia and infection at the discretion
of the local teating physician and availability of the drug. All members
met weekly by video conference through www.cure4Kids.org to discuss
problem cases.