SWOG-9133 RT w/ or w/o Doxorubicin and Vinblastine in Stage I or Stage II Hodgkin's Disease

OBJECTIVES: I. Compare progression-free and overall survival of patients with clinical Stage
IA/IIA Hodgkin's disease who have not undergone laparotomy and who are randomized to
treatment with subtotal nodal irradiation with vs. without 3 courses of
doxorubicin/vinblastine. II. Compare the long-term toxicities associated with these
treatments, including cardiopulmonary toxicity, secondary malignancies, and infertility.
III. Identify subgroups of patients (based on age, gender, tumor histology, number of
disease sites, and presence of high neck presentation) that are particularly responsive to
these treatments.

OUTLINE: Randomized study. Arm I: Radiotherapy. Subtotal nodal irradiation using megavoltage
equipment (4-10 MeV). Arm II: 2-Drug Combination Chemotherapy followed by Radiotherapy.
Doxorubicin, DOX, NSC-123127; Vinblastine, VBL, NSC-49842; followed by subtotal nodal
irradiation as in Arm I.

PROJECTED ACCRUAL: 210 patients/arm will be enrolled over about 7 years.

DISEASE CHARACTERISTICS: Biopsy-proven Hodgkin's disease, subclassified according to the
Rye system Clinical Stages IA, IEA, IIA, and IIEA according to modified Ann Arbor system
Staging laparotomy not allowed Completely resected disease allowed Residual disease, if
present, must be bidimensionally measurable No mediastinal mass greater than 1/3 the
maximum chest diameter No infradiaphragmatic presentation No pericardial E lesions (small
pericardial effusions in the absence of nodular pericardial disease allowed) Concurrent
registration on protocol SWOG-9208 (quality-of-life study) required unless patient does
not understand or read English

PATIENT CHARACTERISTICS: Age: 16 and over Performance status: SWOG 0-2 Hematopoietic: AGC
at least 2,000 Platelets within normal limits Hepatic: Bilirubin within normal limits
Renal: Creatinine within normal limits Cardiovascular: LVEF normal No serious EKG
abnormality Pulmonary: No serious pulmonary condition Other: No serious medical condition
other than Hodgkin's disease No known AIDS or HIV-associated complex No second malignancy
within 5 years except: Adequately treated nonmelanomatous skin cancer Adequately treated
in situ carcinoma of the cervix No pregnant or lactating women Adequate contraception
required of fertile patients Blood/body fluid analyses to determine eligibility completed
within 14 days prior to registration; imaging studies for tumor measurement completed
within 28 days prior to registration; screening exams other than blood/body fluid
analyses, and imaging studies of nonmeasurable disease or uninvolved organs completed
within 42 days prior to registration

PRIOR CONCURRENT THERAPY: Biologic therapy: No prior biologic therapy Chemotherapy: No
prior chemotherapy for any reason Endocrine therapy: Not specified Radiotherapy: No prior
radiotherapy for any reason Surgery: No staging laparotomy