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Progress in quest to reduce use of radiation in treatment of pediatric Hodgkin lymphoma
Date:6/26/2012

be cured without radiation.

Hodgkin is found in 850 to 900 children and adolescents each year and accounts for an estimated 6 percent of all childhood cancers. The disease strikes the lymph system, which includes the lymph nodes, tonsils and other immune system components.

This study involved 88 patients whose cancer had spread to less than three lymph node groups and surrounding tissue. None of the patients reported fever, weight loss or other symptoms also associated with a worse outcome. About one-third of young Hodgkin lymphoma patients fall into this favorable risk category. The patients were treated between March 2000, and December 2008, at St. Jude; Stanford University Medical Center; Dana-Farber Cancer Institute and Massachusetts General Hospital, both in Boston; and Maine Medical Center, in Portland. One patient withdrew early and was not included in the results.

The patients all received four rounds of chemotherapy with the drugs vinblastine, Adriamycin, methotrexate and prednisone, a combination known as VAMP. Unlike some other chemotherapy agents used to treat Hodgkin lymphoma, none of these drugs is linked to second cancers or infertility. One, Adriamycin, belongs to a family of drugs that can lead to heart damage, but at much higher cumulative doses.

Radiation was recommended for patients whose tumors had not shrunk at least 75 percent following two rounds of chemotherapy. Those patients received low-dose irradiation of 25.5 grays to the tumor and surrounding tissue.

For patients with a favorable initial response to chemotherapy, omitting radiation had no impact on their survival either two years or five years after their diagnosis. Those patients fared no worse than patients who received radiation therapy after the opening rounds of chemotherapy resulted in only a partial response. All patients followed for at least five years were still alive regardless of their initial treatment.

More than 88 pe
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Contact: Summer Freeman
summer.freeman@stjude.org
901-595-3061
St. Jude Children's Research Hospital
Source:Eurekalert

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