Stanford V (usually spoken as Stanford Five), is a chemotherapy regimen (with accompanying Radiation therapy) intended as a first-line treatment for Hodgkin lymphoma. The regimen was developed in 1988, with the objective of maintaining a high remission rate while reducing the incidence of acute and long term toxicity, pulmonary damage, and sterility observed in alternative treatment regimens such as ABVD.[1] The chemical agents used are:
- A mustard derivative such as cyclophosphamide, chlormethine or ifosfamide
- Doxorubicin, an anti-tumor antibiotic
- Vinblastine, an alkaloid cell toxin
- Vincristine, another alkaloid cell toxin
- Bleomycin, another anti-tumor antibiotic
- Etoposide, a DNA toxin
- Prednisone, a corticosteroid
| Drug | Dose | Mode | Days |
|---|---|---|---|
| Doxorubicin | 25 mg/m2 | IV | Days 1 and 15 |
| Vinblastine | 6 mg/m2 | IV | Days 1 and 15 |
| Chlormethine | 6 mg/m2 | IV | Day 1 |
| Vincristine | 1.4 mg/m2 (max 2 mg) | IV | Days 8 and 22 |
| Bleomycin | 5 units/m2 | IV | Days 8 and 22 |
| Etoposide | 60 mg/m2 | IV | Days 15, 16 |
| Prednisone | 40 mg/m2 | PO | Q2D |
The chemotherapy part of Stanford V treatment can last anywhere from 8 to 12 weeks, depending on the staging of the disease. In many cases, this is followed by radiation therapy for anywhere from 2 to 6 weeks to the affected areas of the body.
Stanford V is a more rigorously administered form of chemotherapy, with treatments roughly twice as fast as those of other Hodgkin lymphoma treatments. However, in a randomized controlled study, Stanford V was inferior to ABVD.[4] This study has been criticized for not adhering to the proper Stanford V protocol. Specifically, the radiation therapy component following chemotherapy was not properly administered in the Italian study. A retrospective study from the Memorial Sloan-Kettering Cancer Center displayed results similar to the Stanford Cancer Center's own experience. The study concluded that, "Stanford V with appropriate radiotherapy is a highly effective regimen for locally extensive and advanced HL."[5]
References
edit- ^ Bartlett NL, Rosenberg SA, Hoppe RT, et al. (1995). "Brief chemotherapy, Stanford V, and adjuvant radiotherapy for bulky or advanced-stage Hodgkin's disease: A preliminary report". J. Clin. Oncol. 13 (5): 1080–1088. doi:10.1200/JCO.1995.13.5.1080. PMID 7537796.
- ^ "Cancer Care Ontario". Formulary. Retrieved 2011-05-27.
- ^ Horning, SJ; Williams J, Bartlett NL; et al. (March 2000). "Assessment of the Stanford V Regimen and Consolidative Radiotherapy for Bulky and Advanced Hodgkin's Disease: Eastern Cooperative Oncology Group Pilot Study E1492". Journal of Clinical Oncology. 18 (5): 972–980. doi:10.1200/jco.2000.18.5.972. PMID 10694546.
- ^ Gobbi, PG; Levis, A; Chisesi, T; et al. (2005). "ABVD versus modified stanford V versus MOPPEBVCAD with optional and limited radiotherapy in intermediate- and advanced-stage Hodgkin's lymphoma: final results of a multicenter randomized trial by the Intergruppo Italiano Linfomi". J. Clin. Oncol. 23 (36): 9198–207. doi:10.1200/JCO.2005.02.907. PMID 16172458.
- ^ Edwards-Bennett SM, Jacks LM, Moskowitz CH, Wu EJ, Zhang Z, Noy A, Portlock CS, Straus DJ, Zelenetz AD, Yahalom J (2010). "Stanford V program for locally extensive and advanced Hodgkin lymphoma: the Memorial Sloan-Kettering Cancer Center experience". Ann. Oncol. 21 (3): 574–81. doi:10.1093/annonc/mdp337. PMID 19759185.
External links
edit- Lymphoma Information Network
- Horning SJ, Hoppe RT, Breslin S, Bartlett NL, Brown BW, Rosenberg SA (February 2002). "Stanford V and radiotherapy for locally extensive and advanced Hodgkin's disease: mature results of a prospective clinical trial". J. Clin. Oncol. 20 (3): 630–7. doi:10.1200/jco.20.3.630. PMID 11821442.
- Includes table for schedule