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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

06/24/2006

Pubmed ID

16794504

DOI

10.1097/00043426-200606000-00008

Scopus ID

2-s2.0-33745677279   69 Citations

Abstract

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 Group

Author

Cindy L. Schwartz MD, MPH Chief, Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
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
jenkins-FCD Prod-461 7d7c6113fc1a2757d2947d29fae5861c878125ab