Objective: To summarize the efficiency and long-term outcomes of limited-stage Hodgkin lymphoma in children and adolescents with ABVD therapy and determined whether omitting radiotherapy for a low-risk patient enabled the achievement of complete response (CR) after chemotherapy. Methods: We retrospectively analyzed data from 13 y (2004-2016) from patients aged ≤18 y with limited-stage HL admitted to the Sun Yat-sen University Cancer Center. Patients received treatment with ABVD chemotherapy alone or ABVD chemotherapy followed by low-dose involved field radiotherapy. Results: Total 85 subjects were eligible for study inclusion; the median age was 12 (3-18) y; 66 (77.6%) were men, 80 (94.1%) had stage-II disease, 56 (65.9%) were at low-risk, and the median follow-up duration was 72 (8-196) months; 12 relapsed, 2 had secondary neoplasm, and 2 died. The 5-year event free survival (EFS) was (85.6±3.8) %, and the overall survival (OS) was 100%. The 5-year EFS and OS was (89.1±4.2) % and 100%, respectively, for the low-risk cohort and (79.3±7.5) % and 100%, respectively for the intermediate-risk cohort. Among the 39 low-risk patients who achieved CR after chemotherapy, 15 received treatment with chemotherapy followed by LD-IFRT. In the exploratory subset analysis, the low-risk cohort who achieved CR after chemotherapy, the 5-year EFS for comparing ABVD alone with chemotherapy followed by LD-IFRT was (87.0±7.0) % versus 100% (P=0.506) , and the OS was 100% for both the groups. Conclusions: Our retrospective analysis showed excellent survival of limited-stage HL patients with ABVD therapy. For patients who achieving CR after chemotherapy with low-risk HL, received chemotherapy followed by LD-IFRT does not improve 5-year OS and EFS. The use of risk- and response-based stratification may facilitate the development of effective and less toxic protocols.
目的： 总结ABVD方案治疗儿童和青少年局限期（Ⅰ/Ⅱ期）霍奇金淋巴瘤（HL）的治疗效果和预后，探讨低危组患者化疗达完全缓解（CR）后可否不放疗。 方法： 回顾性分析2004-2016年在中山大学肿瘤防治中心接受ABVD方案单纯化疗或联合低剂量侵犯野放疗治疗的85例儿童和青少年局限期HL患者的临床资料。 结果： 85例儿童和青少年局限期HL患者的中位年龄12（3~18）岁，男66例，女19例，Ⅰ期5例，Ⅱ期80例，低危组56例，中危组29例。中位随访72（8~196）个月，复发12例，发生第二肿瘤2例，死亡2例。全组5年无事件生存（EFS）率为（85.6±3.8）%，5年总生存（OS）率100%。低危组5年EFS率和OS率分别为（89.1±4.2）%和100%，中危组5年EFS率和OS率分别为（79.3±7.5）%和100%。低危组化疗后达CR者共39例，其中15例化疗后接受放疗，单纯化疗组和化疗联合放疗组5年EFS率分别为（87.0±7.0）%和100%（P=0.506），OS率均为100%。 结论： ABVD方案治疗儿童和青少年局限期HL患者OS率较高，与发达国家相当，低危组化疗后达CR者放疗无获益，鉴于放疗远期不良反应，应根据危险度分层和治疗反应调整治疗强度。.
Keywords: Chemotherapy; Children and adolescents; Hodgkin lymphoma; Limited stage; Radiation.