Radiotherapy for children and adolescents with early-stage classical Hodgkin lymphoma – Authors' reply

Christine Mauz-Körholz and colleagues 1 Mauz-Körholz C Landman-Parker J Fernández-Teijeiro A et al. Response-adapted omission of radiotherapy in children and adolescents with early-stage classical Hodgkin lymphoma and an adequate response to vincristine, etoposide, prednisone, and doxorubicin (EuroNet-PHL-C1): a titration study. Lancet Oncol. 2023; 24: 252-261 Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar reported the results of a titration study that showed radiotherapy can be omitted for children and adolescents with early-stage classical Hodgkin lymphoma and an adequate response to vincristine, etoposide, prednisone, and doxorubicin (OEPA). Based on previous research, 2 Schellong G Brämswig J Ludwig R et al. Combined treatment strategy in over 200 children with Hodgkin's disease: graduated chemotherapy, involved field irradiation with low dosage and selective splenectomy. A report of the cooperative therapy study DAL-HD-82. Klin Padiatr. 1986; 198 (in German).: 137-146 Crossref PubMed Google Scholar , 3 Mauz-Körholz C Hasenclever D Dörffel W et al. Procarbazine-free OEPA-COPDAC chemotherapy in boys and standard OPPA-COPP in girls have comparable effectiveness in pediatric Hodgkin's lymphoma: the GPOH-HD-2002 study. J Clin Oncol. 2010; 28: 3680-3686 Crossref PubMed Scopus (188) Google Scholar the authors used a 5-year event-free survival rate of 90% as a target outcome rate, and found that the 5-year event-free survival was 86·5% (95% CI 83·3–89·8) for patients who had an adequate response without radiotherapy and 88·6% (84·8–92·5) for those with an inadequate response who received radiotherapy. Despite impressive results, we would like to raise some questions for discussion. Response-adapted omission of radiotherapy in children and adolescents with early-stage classical Hodgkin lymphoma and an adequate response to vincristine, etoposide, prednisone, and doxorubicin (EuroNet-PHL-C1): a titration studyOn the basis of all the evidence, radiotherapy could be omitted in patients with early-stage classical Hodgkin lymphoma and an adequate response to OEPA, but patients with risk factors might need more intensive treatment. Full-Text PDF Open AccessRadiotherapy for children and adolescents with early-stage classical Hodgkin lymphoma – Authors' replyWe appreciate the correspondence from Dun-Chang Mo and colleagues on our titration study.1 Full-Text PDF