Radiation not needed after chemo cures Hodgkin’s

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Some kids with Hodgkin’s disease, a form of lymphoma, may not need to undergo radiation treatment, German doctors have found.

A complete remission of Hodgkin’s disease can sometimes be achieved with chemotherapy alone, allowing children to skip radiation therapy altogether, researchers reported Tuesday at the American Society for Therapeutic Radiology and Oncology’s annual meeting.

Dr. Ursula Ruhl, at Moabit Hospital Berlin, led a seven-nation study in which 1018 children with Hodgkin’s were treated with two to six cycles of combination chemotherapy.

The 211 children who achieved a complete remission after chemotherapy alone were not given “consolidating” radiation therapy. Depending on the amount of residual tumor, the other patients were given various doses of radiation.

A total of 916 patients are in continuous complete remission, the investigators reported. There were 38 cases of progressive disease during treatment and 57 relapses after achieving complete tumor control initially.

In the low-risk treatment group, 96 percent are alive and disease free. The no-radiation strategy definitely worked for them, Ruhl told Reuters Health. “Quite a number profited because they did not get radiation therapy at all, with all its potential late effects.”

For the other children, disease-free survival was 92 percent for those who received radiation.

The relapse rate was higher for those not given radiation, but very few children needed high radiation doses. So during the next clinical trial “we can probably cut down the radiation dose” for all but the most advanced cases, Ruhl said.

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