Association Between Radiotherapy vs No Radiotherapy Based on Early Response to VAMP Chemotherapy and Survival Among Children With Favorable-Risk Hodgkin Lymphoma

Metzger, Monika L.; Weinstein, Howard J.; Hudson, Melissa M.; Billett, Amy L.; Larsen, Eric; Friedmann, Alison M.; Howard, Scott C.; Donaldson, Sarah S.; Krasin, Matthew J.; Kun, Larry E.; Marcus, Karen J.; Yock, Torunn I.; Tarbell, Nancy J.; Billups, Catherine A.; Wu, Jianrong; Link, Michael P.

doi:10.1001/jama.2012.5847

Cited by 95 publications

(79 citation statements)

References 35 publications

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“…Similar findings were obtained in studies of pediatric HD (24). This finding was used to make treatment decisions in a clinical trial that included children and adolescents with HD (25). Radiotherapy was added to chemotherapy for patients with positive PET examination results after two cycles of chemotherapy.…”

Section: Discussionsupporting

confidence: 54%

Effect of chemotherapy alone with adult chemotherapy regimens on prognosis of children and adolescents with Hodgkin's disease

Zhen

Guo

Zhu

et al. 2016

Japanese Journal of Clinical Oncology

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Objective: A current focus on the treatment of children and adolescents with Hodgkin's disease is identification of subgroups of patients for whom radiotherapy can be omitted without compromising clinical outcome. We evaluated the feasibility of using adult chemotherapy regimens alone to treat children and adolescents with Hodgkin's disease. Methods: Recruitment inclusion criteria were children and adolescents ≤18 years old who were newly diagnosed as Hodgkin's disease. Chemotherapy comprised four cycles of ABVD, six cycles of ABVD or COPP/ABV and six cycles of BEACOPP/ABVD chemotherapy regimens in the low-, intermediate-and high-risk groups, respectively. Radiotherapy was omitted for patients with lowrisk, nonbulky disease who had achieved complete remission after chemotherapy and patients who failed to undergo the scheduled radiotherapy due to various reasons beyond the disease. Results: Seventy-five children and adolescents were recruited, including 28, 24 and 23 patients in the low-, intermediate-and high-risk groups, respectively. With a median follow-up of 48 months, 4-year event-free survival and 4-year overall survival were 77.6% ± 5% and 95.3% ± 3%, respectively, in the whole cohort. The 4-year event-free survival in the low-, intermediate-and high-risk groups were 88.2% ± 6%, 78.1% ± 9% and 66.2% ± 11%, respectively (P = 0.062). Sixteen patients (21.3%) relapsed and four died from tumor progression. Conclusions: Over three-quarters of children and adolescents with Hodgkin's disease achieved long-term event-free survival after receiving chemotherapy alone with adult chemotherapy regimens, and radiotherapy-related toxicity was avoided.

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Section: Discussionsupporting

confidence: 54%

Effect of chemotherapy alone with adult chemotherapy regimens on prognosis of children and adolescents with Hodgkin's disease

Zhen

Guo

Zhu

et al. 2016

Japanese Journal of Clinical Oncology

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“…33 Moreover, a recent publication on a multi-institutional American trial reported a 2-year EFS rate of 90.8% among 47 children with favorable-risk HL after four cycles of VAMP (vinblastine, doxorubicin, methotrexate, and prednisone) without adjuvant RT, when early response evaluation including functional imaging showed a CR after the first two cycles. 34 Further trials addressing the same question for patients with limited-stage HL are performed by the Children's Oncology Group (AHOD0431) 35 and have also been tested in adults. 36,37,38 Renunciation of RT in the treatment of pediatric HL is aimed at minimizing the risk of radiation-induced late effects, especially of SMN.…”

Section: ‫ء‬mentioning

confidence: 99%

Treatment of Children and Adolescents With Hodgkin Lymphoma Without Radiotherapy for Patients in Complete Remission After Chemotherapy: Final Results of the Multinational Trial GPOH-HD95

Dörffel¹,

Rühl²,

Lüders³

et al. 2013

JCO

127

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“…[49] Bu ça-lışma daha sonra 2000-2008 yılları arasında nonrandomize olarak düşük riskli, tedaviye erken tam cevap veren hastalarda dört kür VAMP sonrası RT uygulanan ve uygulanmayan grup şeklinde değer-lendirildiğinde, iki yıllık EFS'yi RT almayan grupta %89.4; RT alan grupta %92.5 olarak (p=0.61) saptadılar. [65] Bu şekilde alkilleyici ajan, bleomisin, etoposid, radyoterapi kullanılmadan risk adapte, cevap ilişkili tedavi yaklaşımı ile düşük riskli seçilmiş hasta gruplarında uygulanabilecek etkili ve daha iyi tolere edilebilen tedavi şeması olduğunu vurgulamışlardır. [65] St. Jude/Stanford/Dana Farber'da 1993-2000 yılları arasında yüksek riskli hastalarda alkilleyici, antrasiklin ve radyoterapiye bağlı toksisitelerin azaltılması amaçlı risk adapte VAMP/COP'li (vinkristin, adriamisin, methotreksat, prednizolon, cyclofosfamid, vinkristin, prokarbazin) kemoterapi ve sonrasında uyguladıkları cevap ilişkili radyoterapinin değerlendirmelerinde geç rekürrenslerin çok olması nedeni ile çalışma erken sonlandırıldı.…”

Section: Risk Grup Hasta Sayısı Sonuçunclassified

“…[65] Bu şekilde alkilleyici ajan, bleomisin, etoposid, radyoterapi kullanılmadan risk adapte, cevap ilişkili tedavi yaklaşımı ile düşük riskli seçilmiş hasta gruplarında uygulanabilecek etkili ve daha iyi tolere edilebilen tedavi şeması olduğunu vurgulamışlardır. [65] St. Jude/Stanford/Dana Farber'da 1993-2000 yılları arasında yüksek riskli hastalarda alkilleyici, antrasiklin ve radyoterapiye bağlı toksisitelerin azaltılması amaçlı risk adapte VAMP/COP'li (vinkristin, adriamisin, methotreksat, prednizolon, cyclofosfamid, vinkristin, prokarbazin) kemoterapi ve sonrasında uyguladıkları cevap ilişkili radyoterapinin değerlendirmelerinde geç rekürrenslerin çok olması nedeni ile çalışma erken sonlandırıldı. [66] Hastaların beş yıllık EFS'leri %75 olarak saptanarak, yazarlar yüksek riskli hastalarda alkilleyicilerin başarılı tedavide gerekli olduğunu vurguladılar.…”

Section: Risk Grup Hasta Sayısı Sonuçunclassified

Treatment of Hodgkin’s lymphoma in children

Kebudi¹

2015

TJ Oncol

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With the advances in current diagnostics and treatment modalities the survival in children with Hodgkin's lymphoma have significantly increased. The aim of the treatment nowadays is administering the most effective and least toxic treatment. This has leaded to "risk adapted, response and gender modified" treatments. In this review, the treatment modalities and results used in Hodgkin's lymphoma in children within decades have been assessed.

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Association Between Radiotherapy vs No Radiotherapy Based on Early Response to VAMP Chemotherapy and Survival Among Children With Favorable-Risk Hodgkin Lymphoma

Cited by 95 publications

References 35 publications

Effect of chemotherapy alone with adult chemotherapy regimens on prognosis of children and adolescents with Hodgkin's disease

Effect of chemotherapy alone with adult chemotherapy regimens on prognosis of children and adolescents with Hodgkin's disease

Treatment of Children and Adolescents With Hodgkin Lymphoma Without Radiotherapy for Patients in Complete Remission After Chemotherapy: Final Results of the Multinational Trial GPOH-HD95

Treatment of Hodgkin’s lymphoma in children

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