9039 Background: To report on treatment results and prognostic factors of young patients with Hodgkin’s disease treated with chemotherapy (CT) followed by low dose radiotherapy (RT). Methods: This retrospective series analysed 166 patients under 18 years old, treated from January 1985 to December 2003. Median age was 10 years (range 2–18). The male to female ratio was 2,3:1. Adenomegalia was the most frequent complaint (68%), and the time of symptom duration was smaller than 6 months in 55% of the patients. In histological analysis Nodular Sclerosis was the most prevalent type (43%) followed by Mixed Celularity (41%). The disease was restricted to two nodal group ( stage II) in 60% and to adjacent groups in 55% (stage III). The most frequent site of metastasis ware the bone marrow (38%) and lungs (42%). Standard treatment consisted of chemotherapy (drug combination varied according to treatment protocols vigent). Radiotherapy consisted of 21 Gy dose in 17 fractions in most part of patients (90.2%), delivered to involved field or mantle field. 13,86% patients did not receive RT. Results: The OS and EFS in 10 years were 88.6% and 82.4%.Survival according to clinical stage as 94.4%, 94.25%, 90.6% and 71.5% for stages I to IV (p=0.0215). The OS in 90.5% of patients who received RT and in 75.6% of patients who did not (p=0.001). Multivariate analysis showed presence of B symptoms and low platelet count to be associated with a worse prognosis. Conclusions: This study shows that combining chemotherapy and low dose RT is an effective treatment for HL in childhood, providing high rates of cure and disease control (88.6% in 10 years), and that so far it is not possible to abdicar RT. And yet, attention to platelet count should be payed in order to improve survival. Also, B symptom presenting children may be involved in more aggressive protocols so survival can be improved. As the disease is highly curable, any data of long term follow-up should be presented in order to better direct therapy, improving outcome and lowering side effects. No significant financial relationships to disclose.
Chemotherapy followed by low dose radiotherapy in childhood Hodgkin's disease: retrospective analysis of results and prognostic factors