Treatment of favorable, early-stage hodgkin's disease in children and adolescents using vamp and low-dose, involved-field radiation

ABSTRACT

to evaluate outcome and assess, toxicity of children and adolescents with, early-stage, favorable Hodgkin's disease treated with vinblastine, doxorubicin, methotrexate, and prednisone [VAMP] and low-dose, involved-field radiation, Patients and twenty-four patients with clinical stages I and IIA, favorable [nonbulky] Hodgkin's disease were treated with four cycles of VAMP chemotherapy and 15Gy involved field radiation for those who achieved a complete response, or 25.5Gy for those who achieved a partial response to two cycles of VAMP with a median follow-up of 49 months [range, 74 to 66 months], the overall and event-free survival were 95.8% and 87.5%, respectively. The only factor associated with longer event-free survival was the number of initially involved sites. Risk-adapted, combined-modality therapy using only four cycles of VAMP chemotherapy with 15 to 25.5 Gy of involved-field radiation for patients with early-stage/favorable Hodgkin's disease is highly effective and without demonstrable side-effects. These results indicates that patients with stages I and IIA, non-bulky, and involving less than three Ann Arbor sites can be cured with limited therapy that does not include an alkylating agent bleomycin, etoposide, or high-dose extended-field radiation therapy