EXTENDED FIELD- HIGH DOSE VERSUS INVOLVED FIELD- LOW DOSE RADIOTHERAPY ± CHEMOTHERAPY IN PEDIATRIC HODGKIN'S DISEASE

The results of pediatric Hodgkin's disease have been improved after addition of chemotherapy to radiotherapy. However, in the long term, late complications have been reported. To reduce such complications, low-dose involved field radiotherapy and chemotherapy protocols have been considered. In the period 1978-1991, 51 children were treated for Hodgkin's disease at our institution. The cases were treated in two groups. The first group (30 patients) was treated with extended field and high dose radiotherapy with or without chemotherapy and the second group (21 patients) received involved field, low dose radiotherapy with chemotherapy. Thirteen patients recurred in the first group. Eighty percent of those patients had only radiotherapy. Eleven of the 13 recurrences were outside of the radiotherapy fields. The 2- and 5- year disease-free survival were 67% and 49%, overall survival were 79% and 75% respectively. In the second group there was only one recurrence and one case did not respond at the end of therapy. The 2- and 5- year disease-free survival was 93% and overall survival was 94%. While the complication rate was 16% in the first group, no late complication was observed in the second group. It can be concluded that the results of involved field and low dose radiotherapy with chemotherapy are as good as or even better than extended field and high dose radiotherapy plus chemotherapy, with lower complication rates.