Results of a changing treatment philosophy for children with stage I Hodgkin's disease: a 35-year experience.

Abstract

Over the last four decades, significant changes have occurred in the management of childhood stage I Hodgkin's disease. Between 1949 and 1984, 50 children, ages 4 to 16 years, were treated for stage I Hodgkin's disease at The University of Texas M. D. Anderson Cancer Center. Nineteen children had clinically staged (CS) disease. Thirty-one patients were pathologically staged (PS). Thirty-four children were treated with radiotherapy only, 12 were treated with both radiotherapy and chemotherapy, and 3 patients were treated with combination chemotherapy alone. All patients were followed from 32 to 311 months (median 170 months). Five-, 10-, and 15-year actuarial survival rates for all patients were 94, 89, and 84%, respectively. The corresponding freedom from relapse (FFR) rates were 76, 69, and 69% respectively. The 10-year actuarial survival and FFR rates for CS patients were 79 and 42%. The corresponding rates for PS patients were 97 and 86%. In patients with PSI disease, actuarial 10-year FFR rates of 100% were obtained either with regional radiotherapy alone or with combination chemotherapy and involved field radiotherapy. The following delayed adverse effects of treatment were observed: growth abnormalities in 17, aspermia in 3, thyroid abnormalities in 11 (two carcinomas), and second malignancies beyond the radiotherapy fields in 2. We conclude with a recommendation of combined chemotherapy and involved field radiation for children who have not fulfilled their growth potential, to achieve high cure rates, while minimizing morbidity.

• Authors: A S Garden, S Y Woo, L M Fuller, M P Sullivan, I Ramirez
• Journal: Medical and pediatric oncology (Med Pediatr Oncol) Vol. 19 Issue 4 Pg. 214-20 ( 1991) ISSN: 0098-1532 [Print] United States
• PMID: 2056966 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Topics

• Adolescent
• Child
• Child, Preschool
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Growth (radiation effects)
• Growth Disorders (etiology)
• Hodgkin Disease (drug therapy, mortality, pathology, radiotherapy)
• Humans
• Male
• Neoplasm Staging
• Radiation Injuries
• Recurrence
• Survival Rate