Concurrent chemotherapy and radiation therapy in the treatment of childhood and adolescent Hodgkin's disease

Abstract

A treatment program of combination chemotherapy and concurrent radiotherapy was designed for children and adolescents with all stages of Hodgkin's disease. From September, 1967 to April, 1972, 49 patients with previously untreated disease were admitted to the study. They were given 12 weeks of initial chemotherapy in combination with simultaneous radiotherapy at a tumor dose of 3500 to 4000 R. For Stages II-IV chemotherapy was continued for 1 to 2 years. Forty-seven patients responded to therapy with complete remissions; two had no response. Of the patients responding, 40 have been in continuous complete remission for periods of 6 to 58 months, four have relapsed, and three have died in remission. Twenty-six patients have been off all therapy for periods of 4 to 54 months without evidence of active disease. In most instances complications of therapy including drug toxicity, infections and nutritional disturbances have been reversible by modification of chemotherapy and judicious supportive care. We conclude that combination chemotherapy and concurrent irradiation are tolerated by children and adolescents with Hodgkin's disease and result in a high frequency of complete remission. Results to date suggest that the majority of children, even those with advanced stages, will have lengthy complete remissions.