© 1996 Kluwer Academic Publishers. Printed in the Netherlands. Review Current clinical trials in Hodgkin's disease

With the advent of modern polychemotherapy and radiation techniques, cure rates in Hodgkin's disease (HD) have im-proved substantially. This article summarises current con-cepts of treatment for early, intermediate and advanced stage HD. Current strategies focus on the balance between cure rate and toxicity. In early stages, cure rates approach 90% and new strategies mainly try to avoid toxicities. Possible approaches comprise the use of less CT or RT or leaving laparotomy. In advanced stages, polychemotherapy with 8 courses of either M(C)OPP or ABVD or M(CPPP/ABVD is considered to be the treatment of choice, but unsatisfac-tory low complete remission rates, progression-free survival or freedom from treatment failure rates have to be improved. The role of additional radiotherapy after extensive chemo-therapy in the treatment of advanced stages is uncertain. To achieve a better tumour control, new regimens have been developed. The Stanford group initiated the 12-week in-tensified hybrid protocol Stanford V. The German Hodg-kin's Lymphoma Study Group (GHSG) introduced the BEACOPP protocol with time intensification and dose esca-lation of cyclophosphamide and etoposide. The Milan Can-cer Institute tries to improve treatment outcome using high doses of single agents. One problem to be addressed in ongoing and future trials is the identification of high-risk groups allowing an early stratification of patients into more agressive but effective regimens. Risk-adapted therapy might allow further reduction of doses in patients with early-stage Hodgkin's disease. Key words: chemotherapy, clinical trials, current strategies, dose escalation, high-dose single agent chemotherapy, Hodgkin's disease, radiotherapy, time intensification, treat-men