Response-adapted radiotherapy in the treatment of pediatric Hodgkin’s disease: an interim report at 5 years of the German GPOH-HD 95 trial

Rühl, U; Albrecht, Marion; Dieckmann, Karin; Lüders, H; Marciniak, Heinz; Schellenberg, Dörte; Wickmann, L.; Dörffel, W

doi:10.1016/s0360-3016(01)01798-9

Cited by 86 publications

(52 citation statements)

References 36 publications

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“…In contrast, GPOH-HD95 did not support the safe omission of radiation therapy in intermediate and high-risk groups following a complete response to chemotherapy, while CCG 5942 was not able to demonstrate a benefit in these patients. Randomization, risk stratification, chemotherapy, response criteria, and the lack of functional imaging make it hard to directly compare the results of these two studies, however the opposing results indicate that there is still much to be determined regarding the optimal use of risk adaptive strategy in pediatric Hodgkin lymphoma treatment [25][26][27]. As outlined by these and other studies, this strategy is not limited to low risk pediatric Hodgkin lymphoma patients.…”

Section: Discussionmentioning

confidence: 99%

Involved-nodal radiation therapy leads to lower doses to critical organs-at-risk compared to involved-field radiation therapy

Mulvihill

McMichael

Goyal

et al. 2014

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Involved-nodal radiation therapy leads to lower doses to critical organs-at-risk compared to involved-field radiation therapy

Mulvihill

McMichael

Goyal

et al. 2014

Radiotherapy and Oncology

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“…Following two cycles of chemotherapy, 27% of lowrisk patients achieved a CR, defi ned as complete absence of measurable disease. There was no statistically significant difference in EFS or OS at median follow-up of 38 months between low-risk patients who received or did not receive IFRT [13]. A smaller series using two courses of COPP and two courses of ABVD also validated the elimination of radiation in a group of children with stage I and II disease with no bulky disease [30].…”

Section: Table1 Combination Chemotherapy Regimensmentioning

confidence: 87%

“…Additional prognostic factors commonly used to stratify patients into risk categories in recent pediatric and adolescent trials include bulky disease and the number of involved lymph node regions, although precise defi nitions vary among trials. The rapidity of response to initial chemotherapy has been demonstrated to have prognostic signifi cance, leading to the use of "response-directed" therapy that limits total therapy for patients with rapid response and, in some cases, escalates therapy for patients with a slow response [13,17]. Until recently, early response was determined by the percentage reduction in the volume of pretreatment disease, based on CT scan evaluation.…”

Section: Staging and Risk Assessmentmentioning

confidence: 99%

What is the best treatment for children with limited-stage Hodgkin lymphoma?

Keller

Castellino²,

Nachman³

2009

Curr Hematol Malig Rep

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Limited-stage Hodgkin lymphoma remains a challenging problem for pediatric oncologists. Published and investigative treatment regimens represent varied approaches to balance the excellent overall and event-free survival with the substantial potential for long-term sequelae of effective treatment modalities. Regimens incorporating low-dose radiation to smaller fields and chemotherapy that limits cumulative exposure to the agents most closely associated with long-term complications have been shown to be effective for most patients. Investigative approaches to optimize overall therapy focus on identifying which patients require more or less therapy. A recent example is the use of response-based therapy as a means of limiting or omitting radiation for those with an early, rapid response to chemotherapy. Biologic markers that influence risk for treatment failure or treatment-related toxicities have been only minimally defined. This paper reviews recently published treatment regimens for children and adolescents and presents some considerations for choosing a treatment approach for individual patients.

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“…After 1989, the nodular sclerosis subtype became predominant (55%), but the rate is still lower than that 1978-1980 1981-1983 1984-1988 1989-1998 1999- NOS not otherwise specified Table 4 Therapeutic results of treatment for childhood HL according to periods 1978-1980 1981-1983 1984-1988 1989-1998 1999 Fig. 3 Overall survival and relapse-free survival according to stages reported in developed countries (more than 70%) [16,18,23,24]. A predominance of the mixed cellularity type has been reported in many other developing countries [2,4,5,7].…”

Section: Discussionmentioning

confidence: 99%

Lymphome de Hodgkin de l’enfant: expérience de 24 ans au service d’hématologie à Casablanca, Maroc

et al. 2009

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Background: More than 90% of children with Hodgkin lymphoma (HL) can be cured with current treatment modalities. This goal has not, however, been reached in most developing countries. We report here the results of a retrospective study of 24 years' experience in the management of HL in children in one institution in Morocco. Procedure: All cases of histologically confirmed HL in children under 17 years of age seen in our department between 1978 and 2001 were included in this study. The treatment modality varied during the 24-year period but mainly comprised combined chemotherapy and radiation therapy. Results: Two hundred and three patients were included. The mean age of the patients was 10.3 years, and 46% were 10 years old or less. The male:female ratio was 2.9. The mean duration of symptoms before diagnosis was 10.4 months. Lukes-Rye histological types 2 and 3 predominated, representing 40% and 37% of cases, respectively. Advanced stages III and IV represented 55.5% of the cases. After a median follow-up of 10 years, only 134 patients were available for evaluation. The 10-year overall and relapse-free survival rates were 64% and 58%, respectively. Conclusion: The results for this large series of cases of childhood HL in Morocco are similar to those observed in other developing countries. Steps must be taken, however, to reduce the numbers who abandon treatment and to improve the therapeutic results.Keywords Children · Hodgkin lymphoma · Developing country Résumé Contexte : Plus de 90 % des enfants atteints de Lymphome de Hodgkin (LH) peuvent actuellement être guéris. Malheureusement, dans les pays en voie de développement, le taux de guérison de ces patients reste en deçà des résultats rapportés dans les pays développés. Nous rapportons dans une série rétrospective, notre expérience de 24 ans dans la prise en charge d'enfants atteints de LH. Matériels et Méthodes : Tous les patients âgés de moins de 17 ans atteints de LH histologiquement prouvé ont été inclus dans cette étude entre 1978 et 2001. Les modalités thérapeutiques ont varié durant cette période mais étaient essentiellement basées sur l'association chimiothérapie et radiothérapie. Résultats : Deux cent trois patients ont été inclus. L'âge médian des patients est de 10.3 ans et 46 % des patients étaient âgés de 10 ans et moins. Le sex-ratio M/F était de 2.9. La durée des symptômes avant le diagnostic était de 10.4 mois. Les types histologiques 2 et 3 selon la classification de Lukes-Rye prédominaient avec respectivement 40 % et 37 % des cas. Les stages avancés III et IV représentaient 55 %. Après un suivi médian de 10 ans, 134 patients seulement étaient évaluables. La survie globale et la survie sans rechute à 10 ans étaient de 64 % et 58 % respectivement.Conclusion : Les résultats rapportés dans notre série sont similaires à ceux rapportés dans plusieurs études émanant de pays en voie de développement. Des efforts restent à fournir afin de réduire le taux de patients perdus de vue et d'améliorer les résultats thérapeutiques.

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Response-adapted radiotherapy in the treatment of pediatric Hodgkin’s disease: an interim report at 5 years of the German GPOH-HD 95 trial

Cited by 86 publications

References 36 publications

Involved-nodal radiation therapy leads to lower doses to critical organs-at-risk compared to involved-field radiation therapy

Involved-nodal radiation therapy leads to lower doses to critical organs-at-risk compared to involved-field radiation therapy

What is the best treatment for children with limited-stage Hodgkin lymphoma?

Lymphome de Hodgkin de l’enfant: expérience de 24 ans au service d’hématologie à Casablanca, Maroc

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