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Treatment of advanced Hodgkin's disease in pediatric patients
Author(s) -
Lange Beverly,
Littman Philip,
Schnaufer Louise,
Evans Audrey
Publication year - 1978
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197809)42:3<1141::aid-cncr2820420317>3.0.co;2-v
Subject(s) - medicine , procarbazine , copp , stage (stratigraphy) , radiation therapy , prednisone , surgery , cyclophosphamide , vincristine , chemotherapy , enzyme , heme , paleontology , biochemistry , chemistry , heme oxygenase , biology
From 1970 to 1976, twenty patients with stage II E or II B to IV B Hodgkin's disease were treated at Children's Hospital of Philadelphia. Initially, four of the stage II or III patients received planned total nodal irradiation (TNI) alone; three patients developed progressive disease during irradiation, and one relapsed after 18 months. These results with TNI led to the use of combined modality therapy. Sixteen patients (4, stage II E or B; 8, stage III; 4, stage IV) were treated with COPP (cyclophosphamide, Oncovin, prednisone, and procarbazine) and radiation therapy. In 14 patients treatment was started with COPP. Patients with disease below L2 received TNI; the rest received involved field (IF) or extended field (EF) irradiation. No patients treated with combination therapy encountered life‐threatening toxicity. Relapse‐free survival in 12 stage II or III patients is 100% with a median follow‐up of 28 months (range, 24 to 91 months). Only one of four stage IV patients is alive. Combined modality therapy is effective, tolerable therapy for children with stage II B—III Hodgkin's disease. No relapses occurred in 10 patients given less than potentially curative radiation. Smaller radiation fields and lower doses are planned for the future.