Shahida Badsha, M Saleem, C M Anwar.
Experience with a Hybrid Chemotherapy regimen and involved-field Radiotherapy in Paediatric Hodgkin`s Disease.
J Coll Physicians Surg Pak Jan ;9(2):97-9.

Although survival rates have improved dramatically for childhood Hodgkin`s disease current treatment entails substantial risks for the late effects such as infertility, second malignancies and cardiopulmonary toxicities. A treatment regimen was chosen with decreased risks of long term sequelae while maintaining efficacy in terms of response and survival. Sixteen children with newly diagnosed and previously untreated Hodgkin`s disease were registered and monitored over a two year period. After pretreatment evaluation all patients were treated with six cycles of combination chemotherapy-three of chlorambucil, procarbazine, vinblastine and prednisolone (ChIVPP) and three of adriamycin, bleomycin, vincristine and DTIC (ABVD). Residual disease was treated with 15-20 Gy of involved-field irradiation. Patients were followed up at six-monthly intervals with physical examination, ECG, chest radiographs, echocardiography and levels of thyroid hormones. After the twelfth birthday patients underwent assessment for levels of gonadotrophins and male patients for testosterone every six months.The observation period now ranges from eleven months to twenty-five months. Fourteen patients are in continued complete remission. One patient died of bilateral severe pneumonia six weeks after the completion of therapy. No long term adverse effects of treatment have been observed so far. In our experience this regimen is well-tolerated and effective and is expected to reduce the risks for late toxicities. A longer follow up duration is, however, required for definitive evaluation.

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