Olaya-Vargas A, Velasco-Hidalgo L, Rivera-Luna R, Suastegui F, Zarco A

Language: Spanish
References: 13
Page: 60-67
PDF size: 139.62 Kb.

ABSTRACT

Introduction. Purpose: To evaluate outcome and assess toxicity of patients with early-stage Hodgkin lymphoma treated with VAMP and low-dose involved-field radiation.
Methods. Patients with clinical favorable stages Hodgkin lymphoma were treated with 4 cycles of VAMP (vinblastine 6 mg/m²sc, doxorrubicyn 25 mg/m²sc, methotrexate 20 mg/m²sc, and prednisone 40 mg/m²sc) administrated on day 1 and day 15. And 21.6 Gy involved-fied radiation. The overall survival was estimated using Kaplan-Meier and Cox methods.
Results. 17 patients were included, the median age was 7 years. Two patients present progressive disease at 4 and 16 months respectively. The overall survival were 94.12% with follow-up of 66 months (IC 95%), the event-free survival were 88.24% with follow up of 63 months (IC 95%).
Conclusions. The combined modality therapy with chemotherapy and involved-field radiation (21.6 Gy) shows a better overall survival. The radiation toxicity was elevated, for that reason we must try to reduce the dose of radiotherapy at 15 Gy in patients with complete response to treatment.

REFERENCES

1. Lanzkowky P. Pediatric hematologiconcology. Hodgkin’s disease. New York: McGraw-Hill Book Company; 1980. p. 96.

2. Leventhal BG, Donalson SS. Hodgkin’s disease. En: Pizzo PA, Poplack DG, editores. Principles and practice of pediatric oncology. 2nd ed. Philadelphia: J. B. Lippincott Company; 1992. p. 577-95.

3. Olaya-Vargas A. Linfoma de Hodgkin. En: Rivera-Luna R, editor. El niño con cáncer; los padecimientos más comunes para el médico no especialista. México: Editores de Textos Mexicanos; 2007. p. 61-74.

4. Nachman JB, Children’s Cancer Group. Phase III study of adjuvant low dose involved field radiotherapy vs no adjuvant therapy in children with Hodgkin´s disease in CR following chemotherapy as-signed by clinical stage (Summary last Modified 02/1999), CCG-59442, clinical trial, closed, 12/11/1998.

5. Oberlin O. Present and future strategies of treatment in childhood Hodgkin’s lymphomas. Ann Oncol. 1996; 7 Suppl 4: 73.

6. Donaldson SS, Hudson MM, Lamborn KR. AMP and now-dose, involved-field radiation for children and adolescents with favorable, early-stage Hodgkin´s disease: Results of a prospective clinical trial. J Clin Oncol. 2002; 20: 3081-7.

7. Behrendt H, van Bunningen FM, van Leeuwen EF. Treatment of Hodgkin´s disease in children with or without radiotherapy. Cancer. 1987; 59: 1870.

8. Santoro A, Bonadonna G, Valagussa P. Long term results of combined chemotherapy radiotherapy approach in Hodgkin´s disease: Superiority of ABVD plus radiotherapy versus MOPP plus radiotherapy. J Clin Oncol. 1987; 5: 27-37.

9. Hudson MM, Greenwald C, Thompson E, William J, Marina N, Fairclough D, et al. Efficacy and toxicity of multiagent chemotherapy and low dose involved field irradiation in children and adolescent with Hodgkin’s disease. J Clin Oncol. 1993; 11: 100-8.

10. Donaldson SS, Whitaker SJ, Plowman PN, Link MP, Malpas JS. Stage I-II pediatric Hodgkin´s disease: ingterm follow-up demonstrates equivalent survival rates following different management schemes. J Clin Oncol. 1990; 8: 1128.

11. Constantine LS, Donaldson SS, McDougall IR. Thyroid dysfunction after radiotherapy in children with Hodgkin´s disease. Cancer. 1984; 53: 878.

12. Barrett A, Crennan E, Barnes J, Martin J, Radford M. Treatment of clinical stage I Hodgkin´s disease by local radiation therapy alone. Cancer. 1990; 66: 670-4.

13. Smith RS, Chen Q, Hudson MM, Donaldson SS. Prognostic factors for children with Hodgkin´s disease treated with combined modality therapy. J Clin Oncol. 2003; 21: 2026-33.