Unknown

Dataset Information

0

Dose-intensive response-based chemotherapy and radiation therapy for children and adolescents with newly diagnosed intermediate-risk hodgkin lymphoma: a report from the Children's Oncology Group Study AHOD0031.


ABSTRACT: The Children's Oncology Group study AHOD0031, a randomized phase III study, was designed to evaluate the role of early chemotherapy response in tailoring subsequent therapy in pediatric intermediate-risk Hodgkin lymphoma. To avoid treatment-associated risks that compromise long-term health and to maintain high cure rates, dose-intensive chemotherapy with limited cumulative doses was used.Patients received two cycles of doxorubicin, bleomycin, vincristine, etoposide, cyclophosphamide, and prednisone (ABVE-PC) followed by response evaluation. Rapid early responders (RERs) received two additional ABVE-PC cycles, followed by complete response (CR) evaluation. RERs with CR were randomly assigned to involved-field radiotherapy (IFRT) or no additional therapy; RERs with less than CR were nonrandomly assigned to IFRT. Slow early responders (SERs) were randomly assigned to receive two additional ABVE-PC cycles with or without two cycles of dexamethasone, etoposide, cisplatin, and cytarabine (DECA). All SERs were assigned to receive IFRT.Among 1,712 eligible patients, 4-year event-free survival (EFS) was 85.0%: 86.9% for RERs and 77.4% for SERs (P < .001). Four-year overall survival was 97.8%: 98.5% for RERs and 95.3% for SERs (P < .001). Four-year EFS was 87.9% versus 84.3% (P = .11) for RERs with CR who were randomly assigned to IFRT versus no IFRT, and 86.7% versus 87.3% (P = .87) for RERs with positron emission tomography (PET) -negative results at response assessment. Four-year EFS was 79.3% versus 75.2% (P = .11) for SERs who were randomly assigned to DECA versus no DECA, and 70.7% versus 54.6% (P = .05) for SERs with PET-positive results at response assessment.This trial demonstrated that early response assessment supported therapeutic titration (omitting radiotherapy in RERs with CR; augmenting chemotherapy in SERs with PET-positive disease). Strategies directed toward improved response assessment and risk stratification may enhance tailoring of treatment to patient characteristics and response.

SUBMITTER: Friedman DL 

PROVIDER: S-EPMC4220044 | biostudies-literature | 2014 Nov

REPOSITORIES: biostudies-literature

altmetric image

Publications

Dose-intensive response-based chemotherapy and radiation therapy for children and adolescents with newly diagnosed intermediate-risk hodgkin lymphoma: a report from the Children's Oncology Group Study AHOD0031.

Friedman Debra L DL   Chen Lu L   Wolden Suzanne S   Buxton Allen A   McCarten Kathleen K   FitzGerald Thomas J TJ   Kessel Sandra S   De Alarcon Pedro A PA   Chen Allen R AR   Kobrinsky Nathan N   Ehrlich Peter P   Hutchison Robert E RE   Constine Louis S LS   Schwartz Cindy L CL  

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20141013 32


<h4>Purpose</h4>The Children's Oncology Group study AHOD0031, a randomized phase III study, was designed to evaluate the role of early chemotherapy response in tailoring subsequent therapy in pediatric intermediate-risk Hodgkin lymphoma. To avoid treatment-associated risks that compromise long-term health and to maintain high cure rates, dose-intensive chemotherapy with limited cumulative doses was used.<h4>Patients and methods</h4>Patients received two cycles of doxorubicin, bleomycin, vincrist  ...[more]

Similar Datasets

| S-EPMC4433576 | biostudies-literature
| S-EPMC7479761 | biostudies-literature
| S-EPMC6857800 | biostudies-literature
| S-EPMC5584603 | biostudies-literature
| S-EPMC4779061 | biostudies-literature
| S-EPMC3753699 | biostudies-literature
| S-EPMC8763141 | biostudies-literature
| S-EPMC6719299 | biostudies-literature
| S-EPMC4872007 | biostudies-literature
| S-EPMC9209747 | biostudies-literature