The intergroup study of Hodgkin's disease in children: a study of stages I and II

A total of 228 previously untreated children with Hodgkin's disease were treated at two cancer centers. At one, the patients were randomly assigned to receive either radiotherapy of the involved field alone, or radiotherapy of the involved field with chemotherapy. At the second center, patients received either extended-field radiotherapy alone or involved-field radiotherapy with chemotherapy. In both cases the chemotherapy consisted of six courses of mechlorethamine, vincristine, prednisone, and procarbazine. Five years after treatment, the groups which received adjuvant chemotherapy in addition to involved-field radiotherapy had significantly better relapse-free survival, at 97 percent and 93 percent at the two centers. However, despite having more relapses, the two groups receiving radiotherapy alone had a comparable overall five-year survival to those receiving adjuvant chemotherapy. In this study the extended-field radiation alone was superior to the involved-field radiotherapy for relapse-free survival at 67 and 41 percent respectively, but the patients were not randomized between the two centers conducting the study. Since the overall survival was not significantly changed by the chemotherapy, the benefits of remaining relapse-free must be weighed against the disadvantages of chemotherapy, including sterility and infection, in deciding on the appropriate course of treatment for Hodgkin's disease in children. (Consumer Summary produced by Reliance Medical Information, Inc.)