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Survival and long-term toxicities of pediatric Hodgkin lymphoma after combined modality treatment: a single institute experience

Radiation Oncology Journal 2020년 38권 3호 p.198 ~ 206
송계진, 박진홍, 임호준, 안승도,
소속 상세정보
송계진 ( Song Kye-Jin ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology
박진홍 ( Park Jin-Hong ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology
임호준 ( Im Ho-Joon ) - University of Ulsan College of Medicine Asan Medical Center Children’s Hospital Department of Pediatrics
안승도 ( Ahn Seung-Do ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology

Abstract


Purpose: To analyze the clinical outcomes and long-term toxicity of pediatric patients with Hodgkin lymphoma after combined-modality treatment (CMT) with involved-field or involved-nodal radiotherapy (RT).

Materials and Methods: We retrospectively reviewed the records of 27 pediatric Hodgkin lymphoma patients who received CMT at a single institution between January 1990 and July 2017. Patients with stage I?III received a heterogeneous chemotherapy regimen depending on their risk group followed by 19.8?36 Gy RT, with the dose based on their response to the chemotherapy before RT. An optional 9?20 Gy boost was delivered to residual sites. The risk group was determined based on the initial stage, the presence of bulky disease, and any B symptoms. We evaluated overall survival, event-free survival, and long-term toxicities.

Results: A total of 27 patients completed the CMT. At a median follow-up of 125 months (range, 9 to 337 months), the estimated 5-year event-free survival and overall survival were 88.9% and 96.3%, respectively. Late symptomatic cardiopulmonary toxicity was not observed, and only one patient was positive on a subclinical obstructive pulmonary function test. The incidence of hypothyroidism was 58.3% among 12 patients with an available thyroid function test. There was one papillary thyroid cancer diagnosed 7.2 years after treatment.

Conclusion: CMT for pediatric Hodgkin lymphoma with involved-field and involved-nodal RT achieved an excellent survival with only modest long-term toxicity. Smaller-field RT seemed to decrease long-term toxicities and had good local control.

키워드

Pediatrics; Hodgkin disease; Radiotherapy; Survival; Long-term adverse effects

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