Covarrubias-Espinoza G, Rendón-García H, Esquer-Cota OO

Language: Spanish
References: 37
Page: 29-36
PDF size: 169.15 Kb.

ABSTRACT

Background: A common place of presentation in Hodgkin’s disease (HD) in children is the mediastinum; it is present in 60% of patients. The mediastinal tumor has been considered as an adverse prognostic factor, and even more when its size mediastinal mass ratio (MMR) is bigger than one third. There has not been a standard treatment, having different trends on the right kind of treatment.
Objectives: Identify prognosis factors Mediastinal Mass (MM) and HD. Evaluate chemotherapy (CT) and radiotherapy (RT) behavior in patients with MM and HD.
Methods: A retrospective analysis in the “Hospital Infantil del Estado de Sonora” in a 20 year period. We found 51 patients with HD and only 14 with MM. We analyzed sex, age, day of treatment, histological type, and behavior during treatment, progression free survival and overall survival.
Results: The mean age was 12 year old, with a male: female ratio of 2.5:1. Fifty percent of the patients had liver and spleen growth, 13 patients had advanced stage HD and B symptoms. Nodular sclerosis was the most common histological type, twelve patients. Hemoglobin, lactic deshidrogenase, alkaline phosphatase, erythrocyte sedimentation rate, was the predictive relapse parameters.
MMR bigger than one third was found in nine patients. The treatment of choice was ABVD/ABV (12 patients). Five of the 14 cases got cured and never relapsed (0.35) and only one of them had a MMR › 1/3. Seven patients relapsed in an average time of 18 months and six of them had a MMR › 0.33. Two died (0.14) and after second line treatment and RT 5 achieved remission. At the end of this analysis two patients had partial remission. Ten patients are disease free (79%) with a median time of 19.8 months. Global survival rate was 85.7%.
Conclusions: Combined CH and RT therapy is effective in the treatment for advanced stage Hodgkin’s disease with MMR › 0.33. MMR › 0.33 is an important prognostic factor.

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