26744
document
POG 8625 : a randomized trial comparing chemotherapy with chemoradiotherapy for children and adolescents with Stages I , IIA , IIIA1 Hodgkin Disease : a report from the Children 's Oncology Group . To determine if 6 courses of chemotherapy alone could achieve the same or better outcome than 4 courses of chemotherapy followed by radiation therapy ( chemoradiotherapy ) in pediatric and adolescent patients with Hodgkin disease . Children < or =21 years old with biopsy-proven , pathologically staged I , IIA , or IIIA1 Hodgkin disease were randomly assigned 6 courses of alternating nitrogen mustard , oncovin , prednisone , and procarbazine/doxorubicin , bleomycin , vinblastine , and dacarbazine ( treatment 1 ) or 4 courses of alternating nitrogen mustard , oncovin , prednisone , and procarbazine/doxorubicin , bleomycin , vinblastine , and dacarbazine +2550 cGy involved-field radiotherapy ( treatment 2 ) . The complete response rate was 89 % , with a complete response and partial response rate of 99.4 % . There was no statistically significant difference in event-free survival ( EFS ) or overall survival between arms . The EFS for those who achieved an early complete response was significantly higher than for those who did not . For pediatric patients with asymptomatic low-stage and intermediate-stage Hodgkin disease , chemotherapy and chemoradiotherapy both resulted in 3-year EFS of approximately 90 % and statistically indistinguishable 8-year EFS and overall survival , without significant long-term toxicity . Early response to therapy was associated with higher EFS , a concept that has led to the Children 's Oncology Group paradigm of response-based risk-adapted therapy for pediatric Hodgkin disease .
26745
Intervention_Pharmacological
chemotherapy
26746
Intervention_Physical
chemoradiotherapy
26747
Intervention_Pharmacological
chemotherapy
26748
Intervention_Pharmacological
chemotherapy
26749
Intervention_Physical
radiation therapy ( chemoradiotherapy )
26750
Intervention_Pharmacological
alternating nitrogen mustard , oncovin , prednisone , and procarbazine/doxorubicin , bleomycin , vinblastine , and dacarbazine ( treatment 1 )
26751
Intervention_Pharmacological
nitrogen mustard
26752
Intervention_Pharmacological
oncovin
26753
Intervention_Pharmacological
prednisone
26754
Intervention_Pharmacological
procarbazine/doxorubicin
26755
Intervention_Pharmacological
bleomycin
26756
Intervention_Pharmacological
vinblastine
26757
Intervention_Pharmacological
dacarbazine +2550 cGy
26758
Intervention_Physical
radiotherapy ( treatment 2 ) .
26759
Intervention_Pharmacological
chemotherapy
26760
Intervention_Physical
chemoradiotherapy
26761
Outcome_Physical
event-free survival ( EFS ) or overall survival
26762
Outcome_Physical
EFS
26763
Outcome_Physical
complete response
26764
Outcome_Physical
3-year EFS
26765
Outcome_Other
8-year EFS
26766
Outcome_Other
overall survival
26767
Outcome_Other
long-term toxicity .
26768
Outcome_Other
response to therapy
26769
Outcome_Other
EFS
26770
Participant_Condition
Stages I , IIA , IIIA1 Hodgkin Disease
26771
Participant_Age
pediatric
26772
Participant_Age
adolescent
26773
Participant_Condition
Hodgkin disease
26774
Participant_Age
Children
26775
Participant_Condition
biopsy-proven , pathologically staged I , IIA , or IIIA1 Hodgkin disease
26776
Participant_Age
pediatric
26777
Participant_Condition
asymptomatic low-stage and intermediate-stage Hodgkin disease