Chemo, Low-Dose Radiation May Treat Hodgkin's Lymphoma
Late toxicity, secondary malignancies low or absent during 8.5-year follow-up
WEDNESDAY, Dec. 27 (HealthDay News) -- A combined chemotherapy/low-dose, extended-field radiotherapy regimen appears to be an effective treatment for children with Hodgkin's lymphoma with minimal side effects, according to a report in the Dec. 20 issue of the Journal of Clinical Oncology.
Mark L. Greenberg, M.B.Ch.B., from The Hospital for Sick Children in Toronto, Ontario, Canada, and colleagues reviewed the outcome of 123 children with Hodgkin's lymphoma treated with at least three cycles of mechlorethamine, vincristine, procarbazine, prednisone (MOPP)/doxorubicin, bleomycin, vinblastine (ABV), with or without 15 Gray (Gy) of extended field irradiation.
Children with stages I-IIIB received three cycles of MOPP/ABV followed by 15 Gy of extended field irradiation; those with stage IV disease received six to eight cycles of MOPP/ABV with or without radiation. The estimated 10-year and event-free survival for all patients was 94 percent and 88 percent, respectively. There were 12 treatment failures and six deaths. The incidence of late cardiopulmonary toxicity, secondary leukemia or solid malignancies were low or absent. The incidence of hypothyroidism was 14 percent.
"Our results should be viewed in the context of response-adapted therapy, the foundation for current Hodgkin's lymphoma trials," the authors write. "This hybrid approach could effectively serve as initial treatment for high-risk patients (stage III-IV disease) coupled with evaluation for early response after two cycles."