POG 8625: a randomized trial comparing chemotherapy with chemoradiotherapy for children and adolescents with Stages I, IIA, IIIA1 Hodgkin Disease: a report from the Children's Oncology Group. J Pediatr Hematol Oncol 2006 Jun;28(6):362-8
Date
06/24/2006Pubmed ID
16794504DOI
10.1097/00043426-200606000-00008Scopus ID
2-s2.0-33745677279 (requires institutional sign-in at Scopus site) 79 CitationsAbstract
To determine if 6 courses of chemotherapy alone could achieve the same or better outcome than 4 courses of chemotherapy followed by radiation therapy (chemoradiotherapy) in pediatric and adolescent patients with Hodgkin disease. Children < or =21 years old with biopsy-proven, pathologically staged I, IIA, or IIIA1 Hodgkin disease were randomly assigned 6 courses of alternating nitrogen mustard, oncovin, prednisone, and procarbazine/doxorubicin, bleomycin, vinblastine, and dacarbazine (treatment 1) or 4 courses of alternating nitrogen mustard, oncovin, prednisone, and procarbazine/doxorubicin, bleomycin, vinblastine, and dacarbazine +2550 cGy involved-field radiotherapy (treatment 2). The complete response rate was 89%, with a complete response and partial response rate of 99.4%. There was no statistically significant difference in event-free survival (EFS) or overall survival between arms. The EFS for those who achieved an early complete response was significantly higher than for those who did not. For pediatric patients with asymptomatic low-stage and intermediate-stage Hodgkin disease, chemotherapy and chemoradiotherapy both resulted in 3-year EFS of approximately 90% and statistically indistinguishable 8-year EFS and overall survival, without significant long-term toxicity. Early response to therapy was associated with higher EFS, a concept that has led to the Children's Oncology Group paradigm of response-based risk-adapted therapy for pediatric Hodgkin disease.
Author List
Kung FH, Schwartz CL, Ferree CR, London WB, Ternberg JL, Behm FG, Wharam MD, Falletta JM, de Alarcon P, Chauvenet AR, Children's Oncology GroupAuthor
Cindy L. Schwartz MD, MPH Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Antineoplastic Agents
Antineoplastic Combined Chemotherapy Protocols
Bleomycin
Child
Child, Preschool
Combined Modality Therapy
Disease-Free Survival
Female
Hodgkin Disease
Humans
Male
Mechlorethamine
Neoplasm Staging
Prednisone
Procarbazine
Remission Induction
Vinblastine
Vincristine