- Combined modality therapy (CMT) with chemotherapy followed by radiotherapy (RT) is associated with a better 5-year survival than chemotherapy alone in children with early-stage Hodgkin lymphoma (HL).
- Despite this, CMT's use has declined by 24.8% since 2004 over concerns about long-term sequelae of RT.
Why this matters
- Findings support the use of CMT as the standard of care, or at least as standard for clinical trials.
- Retrospective observational cohort (n=5657) of pediatric patients (age, 0.1-21 years) with stage I or II classic HL in the US National Cancer Database.
- Funding: None disclosed.
- Median follow-up was 5.1 years.
- CMT was associated with superior 5-year OS (97.3% vs 94.5% with chemotherapy alone), which on multivariate analysis had an adjusted HR (aHR) of 0.57 (P<.001>
- The greatest survival benefit of CMT, based on sensitivity analysis, was for adolescent and young adults (aHR, 0.47; P<.001 and low-risk i-iia patients ci>
- From 2004 to 2015, CMT's use declined by 24.8% (from 59.7% to 34.9%).
- Retrospective observational design.
- Did not examine toxicity.