Hodgkin Lymphoma Management; A 20-year Retrospective Study

Abstract

Object: Hodgkin lymphoma (HL) is one of the pediatric and adult cancers, with a cure rate of over 90% and high long-term survival rates by treatment with chemotherapy alone or combined with radiotherapy (RT). However, survivors of pediatric HL are at high risk of secondary cancers and cardiovascular disease due to treatment. Considering the complications of RT, we aimed to evaluate the consequences and outcomes of the treatment with and without RT in a retrospective study in the pediatric oncology department of Urmia medical sciences university.Method: We carried a cross-sectional retrospective study by referring and review of records for all patients admitted in Motahari hospital with HL diagnosis from 1995 to 2016. The incomplete records and taking chemotherapy out of protocol were our exclusion criteria. The staging of disease was classified by the Ann Arbor staging system.Results: 35 patients enrolled in our study that 54.3% were female and 45.7% were male patients. The mean age of patients was 10.08±6.38 years. 10 (28.6%) cases classified in stage 1, 13 (37.1%) case in stage 2, 9 (25.7%) cases in stage 3, and 3 (8.6%) cases in stage 4. 30 patients (85.7%) were treated by chemotherapy and 5 (14.3%) patients with chemotherapy and radiation combination. In our study, the overall survival was 97.1% of patients who treated with chemotherapy alone and one patient died due to drug side effects. That is comparable with the result of other studies that treated patients with chemotherapy and radiotherapy.Conclusion: According to our findings chemotherapy without radiotherapy as initial treatment in Hodgkin lymphoma would have similar results of concomitant radiotherapy and chemotherapy, so with consideration of cost and harms of radiation therapy, we suggest a limitation of radiation therapy to patients with resistant disease that do not respond to chemotherapy solo-protocols.