Effects of Intensive Induction Chemotherapy on Consolidation Radiotherapy in Young Children with High-risk Hodgkin Lymphoma / 中国药房

ABSTRACT

OBJECTIVE:To investigate the safety of induction chemotherapy and the implementation method of consolidation radiotherapy in young children with high-risk Hodgkin lymphoma(HL),by evaluating the effects of intensive induction chemother-apy on consolidation radiotherapy. METHODS:Six pediatric patients with high-risk HL received low-dose involved field radiation therapy (IFRT) via volumetric modulated arc therapy (VMAT) following 6 cycles of intensive chemotherapy [Ara-C/VP16 (cyto-sine arabinoside+etoposide),ABVE-PC(adriamycin+bleomycin+leurocristine+etoposide+metacortandracin+cyclophosphamide)and CHOP(cyclophosphamide+leurocristine+adriamycin+ prednisone)in turn]. Therapeutic efficacy and toxic effects were evaluated af-ter treatment. RESULTS:Intensive induction chemotherapy and consolidation radiotherapy were acceptable by young children,and mild acute or subacute toxic reaction were observed. Intensive induction chemotherapy didn’t affect toxic effects of consolidation ra-diotherapy. In this regimen,the cumulative doses of bleomycin and adriamycin were 20 mg/m2 and 270 mg/m2,respectively. VMAT optimized plan to ensure that the dose that involved organs received was safe. In the patient with mediastional radiation therapy,the mean lung and heart doses were 525.6 cGy and 503.9 cGy,respectively. CONCLUSIONS:It is safe to give high-risk HL young children 6 cycles of intensive induction chemotherapy(Ara-C/VP16,ABVE-PC and CHOP in turn)before radiotherapy. It is feasi-ble to conduct IFRT with 18-20 Gy and an additional 20-25 Gy boost,1.5-1.8 Gy/fraction. VMAT deserves to be advised.