This paper reports the preliminary results of a controlled study randomizing MOPP vs. a new four-drug combination (ABVD) in advanced Hodgkin's disease. ABVD consists of 6 cycles of adriamycin, bleomycin, vinblastine, and imidazole carboxamide. The purpose for designing this new combination was two-fold: to compare the efficacy of ABVD with MOPP, and to demonstrate absence of cross-resistance between the two regimens. Of 60 patients entered into the study, 45 (MOPP 25, ABVD 20) are presently evaluable for the analysis of remission induction. No patient was previously treated with chemotherapy; 20W had relapsed after primary radiotherapy. Whenever possible, complete remission was defined also through rebiopsy of known organ involvement.Complete remission occurred in 76% of patients treated with MOPP and in 75% of those given ABVD, with no difference between the two regimens as far as stage (IIIB-IIIs and IV), histologic type, and prior irradiation were concerned. Crossover carried out for progressive disease or for relapse after initial remission showed absence of cross-resistance between MOPP and ABVD. Toxic manifestations after ABVD were in general well tolerated and reversible. T h e percent of optimal dose for each drug was as follows: adriamycin 87%, vinblastine 87%, bleomycin 96%, and imidazole carboxamide 96%. These preliminary results indicate that in terms of complete remission, ABVD could represent a successful alternative to MOPP to be used either in MOPP failures or in sequential combination with MOPP. However, the lack of long-term followup limits at the present time a n adequate comparison between the two treatments.Cancer 36:252-259, 1975.

This retrospective study evaluates the time and site of relapse as well as the median survival of 454 consecutive patients with T3-T4 Nx Mo breast cancer treated with radiation therapy from 1968 to 1972. Radiotherapy was delivered with kilovoltage to the first 221 patients and with cobalt to 233 patients, respectively. A group of 133 selected patients was subjected to radical mastectomy 6-8 weeks after completion of the irradiation. The incidence of first relapse was 45% within the first 18 months from starting radiotherapy. The incidence of relapse was higher in presence than in absence of regional adenopathy, with no statistical difference between T3 and T4. Inflammatory carcinoma showed the highest percent of relapse during the first 12 months (48%). The relapse rate appeared independent from type of irradiation. The site of first relapse occurred more often (68%) in areas distant from irradiation fields. Sterilization of both primary tumor and regional nodes was obtained only in 10% of patients. The median survival for the whole series was 2.5 years, with no significant difference between roentgen therapy (3 years) and cobalt (2.5 years). Unfavorable survival was directly related to the presence of regional adenopathies (2.3 years), especially in the supraclavicular fossa (1.4 years) and of inflammatory carcinoma (1.2 years). Patients treated with radiotherapy followed by surgery showed a median survival of 3.9 years compared to 2.1 years for those given only irradiation. The importance of sequentially combining chemotherapy with radiotherapy is discussed.

Ultrasonography with high-frequency probes was performed on 80 dermatological patients carrying palpable lesions of the skin. The case list included hemo- and lymphangiomas (16 cases), cysts (13 cases), Kaposi sarcomas (9 cases), and panniculitis (20 cases). All lesions underwent open biopsy and histological examination. Ultrasound yielded technically adequate images in 74/80 cases (93%). Angiomas appeared as multiple transonic cavities separated by hyperechoic septa; cysts were usually echo free or weakly echogenic, with smooth outlines. Kaposi sarcomas corresponded to superficial hypoechoic nodules with blurred margins, while panniculitis appeared as a diffuse thickening of the subcutaneous space. When acute inflammation was present, as in most cases of erythema nodosum, a nonhomogeneous hypoechoic pattern was found.

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