RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor
cells. Combining more than one chemotherapy drug with radiation therapy may kill more tumor
PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy plus
radiation therapy in treating patients who have early stage Hodgkin's disease.
OBJECTIVES: I. Determine the progression-free and overall survival at 5 and 10 years after a
short-term Stanford V regimen comprising mechlorethamine, doxorubicin, vinblastine,
prednisone, vincristine, bleomycin, and etoposide followed by modified involved-field
radiotherapy in patients with favorable, early-stage Hodgkin's disease. II. Determine
whether the early and late toxic effects of treatment can be minimized by avoiding staging
laparotomy, limiting cumulative doses of chemotherapeutic drugs, and reducing the dose and
volume of radiotherapy in these patients. III. Determine the freedom from second disease
progression at 5 and 10 years after treatment and treatment-related toxicity in these
patients. IV. Determine the quality of life of patients treated with this regimen.
OUTLINE: Patients receive the Stanford V regimen comprising mechlorethamine IV on days 1 and
29; doxorubicin IV and vinblastine IV on days 1, 15, 29, and 43; oral prednisone every other
day on days 1-36 followed by tapered doses; vincristine IV and bleomycin IV on days 8, 22,
36, and 50; and etoposide IV on days 15, 16, 43, and 44. Beginning 2 weeks after completion
of chemotherapy and when blood counts recover, patients undergo modified involved-field
radiotherapy 5 days a week for 3-4 weeks. Quality of life is assessed. Patients are followed
every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study within 5 years.
DISEASE CHARACTERISTICS: Histologically proven stage I-IIA Hodgkin's disease No lymphocyte
predominant disease No stage IA high neck presentation (above the top of the larynx) No
mediastinal mass equal to or greater than one-third the maximum intrathoracic diameter on
chest x-ray No constitutional (B) symptoms at diagnosis No more than 1 extranodal site of
PATIENT CHARACTERISTICS: Age: 16 to 60 Performance status: Not specified Hematopoietic:
Granulocyte count at least 2,000/mm3 Platelet count at least 150,000/mm3 Hepatic:
Bilirubin no greater than 2.5 mg/dL Renal: Creatinine no greater than 2 mg/dL Other: No
other medical condition that would preclude study therapy HIV negative No other prior
malignancy except basal cell skin cancer Not pregnant
PRIOR CONCURRENT THERAPY: No prior therapy for Hodgkin's disease No other concurrent
antineoplastic therapy No other concurrent investigational drugs