en.Wedoany.com Reported - A U.S. Phase II clinical trial shows that after 8 weeks of treatment with a dose-intensive modified Stanford V chemotherapy regimen, most children with low-risk Hodgkin lymphoma can achieve complete remission, thereby avoiding radiation therapy. Among 72 evaluable patients, 76.4% achieved complete remission without receiving radiotherapy, with a 5-year overall survival rate of 100%.
The study, led by Dr. Jamie E. Flerlage from the University of Rochester Medical Center in New York and Dr. Angela M. Feraco from Dana-Farber Cancer Institute in Boston, enrolled 85 previously untreated children with stage IA or IIA low-risk Hodgkin lymphoma. The median age of patients was 14.4 years, with no mediastinal mass or extranodal extension, and fewer than three involved sites. The treatment regimen included a combination of vinblastine, doxorubicin, vincristine, bleomycin, mechlorethamine, etoposide, and prednisone.
The primary goal of the study was to increase the complete remission rate after chemotherapy. Results showed that among all 85 patients, the 5-year event-free survival rate was 87.4%, and the overall survival rate was 98.7%. Among the 55 children who achieved complete remission, the 5-year event-free survival rate was 88.7%. The 16 patients who did not achieve complete remission received tailored radiotherapy, with this group having a 5-year event-free survival rate of 80.7% and an overall survival rate of 93.3%.
Regarding acute toxicity, grade 3-4 neutropenia affected 47% of patients, while lymphocytopenia and anemia accounted for 24.7% and 8.2%, respectively. Late toxicities were less common and included hypothyroidism and pulmonary function abnormalities. The study authors noted: "The dose-intensive modified Stanford V regimen reduced the proportion of children with low-risk Hodgkin lymphoma requiring radiotherapy, but given the small sample size, the results should be interpreted with caution."
Experts from Weill Cornell Medicine commented in an editorial: "This trial demonstrates that more effective systemic therapy can reduce the need for radiotherapy while maintaining excellent outcomes. However, the ideal chemotherapy regimen to achieve this goal still requires further exploration." Study limitations included a single-arm design, small sample size, and issues such as the unavailability of mechlorethamine. The study was published in the journal *Blood* and received support from institutions including Sinopec.
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