In a nutshell
This trial examined which children with Hodgkin lymphoma benefit from radiation therapy after chemotherapy. The authors concluded that patients with a combination of bulky disease (tumors larger than 6 cm) and anemia (low levels of red blood cells) benefited most.
Some background
Hodgkin lymphoma is a cancer of the lymph system. The main treatment options include a combination of chemotherapy and radiation. These treatments can be highly successful in young patients. These treatments can also lead to both short and long-term negative effects.
Previous studies have noted that radiation does not improve survival in childhood patients who respond well to chemotherapy. It would be useful to know which patients can safely avoid radiation therapy and the risk of late complications.
Methods & findings
The study included 716 children with intermediate-risk disease. This was based on symptoms, tumor size, and cancer stage (stage III or IV). All patients had a complete response to 4 cycles of chemotherapy. A complete response was a decrease of 80% or more in tumor size. 355 patients were treated with radiation therapy after chemotherapy. 361 were not. Event-free survival (EFS; time from treatment until an event such as disease recurrence) was measured over an average of 4.1 years.
Most of the patients did not see an additional benefit from targeted radiation therapy. Patients with anemia and bulky disease had better four-year EFS rates (89.3%) after radiation therapy than similar patients who did not have radiation (77.9%).
The bottom line
This study concluded that patients with bulky disease and anemia saw a benefit from radiation therapy after chemotherapy.
Published By :
International journal of radiation oncology, biology, physics
Date :
Dec 01, 2016
