Treatment of pediatric Hodgkin's disease with chemotherapy alone or combined modality therapy

Optimal treatment for Hodgkin's disease during childhood is unknown. We rep ort the treatment outcome of patients with Hodgkin's disease less than or e qual to 13 years of age seen at the American University of Beirut Medical C enter (AUBMC) between 1980 and 1996. A retrospective review of the medical records of 24 children treated for HD at AUBMC was performed. Treatment con sisted of chemotherapy alone (n = 15) or chemotherapy plus involved field r adiotherapy (n = 9). Chemotherapy consisted of CORP, ABVD, or alternating c ycles of each for a total of 6 to 12 cycles, depending on clinical and radi ological response; three patients received MOPP. Five patients in the chemo therapy group had clinical stage (CS) I and II and 10 had CS III disease. I n the combined modality group, eight patients had CS I and II and one had C S IV disease. At a median follow-up of 5 years, the event-free survival (EF S) for the combined modality group was 100% and the overall survival (OS) 1 00%. For the chemotherapy alone group, the EFS was 56% and the OS was 79%. Four patients (27%) in the chemotherapy alone group who had Stage IIIB dise ase relapsed. Mean time to relapse was 4.3 years. In our experience, six cy cles of COPP or (COPP plus ABVD) alone were suboptimal. for the treatment o f Stage IIIB Hodgkin's disease patients, especially those with involvement of lower abdominal nodes (III2B), extensive pulmonary disease, or mixed cel lularity histology. Radiation therapy or additional chemotherapy courses ar e required for these patients. Radiat. Oncol. Invest. 7:365-373, 1999. (C) 1999 Wiley-Liss, Inc.