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Author Charpentier, Anne-Marie ♦ Friedman, Debra L. ♦ Wolden, Suzanne ♦ Schwartz, Cindy ♦ Gill, Bethany ♦ Sykes, Jenna ♦ Albert-Green, Alisha ♦ Kelly, Kara M. ♦ Constine, Louis S. ♦ Hodgson, David C.
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword RADIOLOGY AND NUCLEAR MEDICINE ♦ BIOMEDICAL RADIOGRAPHY ♦ CHEMOTHERAPY ♦ CHILDREN ♦ LYMPHOMAS ♦ RADIATION HAZARDS ♦ RADIOTHERAPY
Abstract Purpose: To evaluate whether clinical risk factors could further distinguish children with intermediate-risk Hodgkin lymphoma (HL) with rapid early and complete anatomic response (RER/CR) who benefit significantly from involved-field RT (IFRT) from those who do not, and thereby aid refinement of treatment selection. Methods and Materials: Children with intermediate-risk HL treated on the Children's Oncology Group AHOD 0031 trial who achieved RER/CR with 4 cycles of chemotherapy, and who were randomized to 21-Gy IFRT or no additional therapy (n=716) were the subject of this study. Recursive partitioning analysis was used to identify factors associated with clinically and statistically significant improvement in event-free survival (EFS) after randomization to IFRT. Bootstrap sampling was used to evaluate the robustness of the findings. Result: Although most RER/CR patients did not benefit significantly from IFRT, those with a combination of anemia and bulky limited-stage disease (n=190) had significantly better 4-year EFS with the addition of IFRT (89.3% vs 77.9% without IFRT; P=.019); this benefit was consistently reproduced in bootstrap analyses and after adjusting for other prognostic factors. Conclusion: Although most patients achieving RER/CR had favorable outcomes with 4 cycles of chemotherapy alone, those children with initial bulky stage I/II disease and anemia had significantly better EFS with the addition of IFRT as part of combined-modality therapy. Further work evaluating the interaction of clinical and biologic factors and imaging response is needed to further optimize and refine treatment selection.
ISSN 03603016
Educational Use Research
Learning Resource Type Article
Publisher Date 2016-12-01
Publisher Place United States
Journal International Journal of Radiation Oncology, Biology and Physics
Volume Number 96
Issue Number 5


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