Treatment of childhood Hodgkin's disease without radiotherapy.

BACKGROUND To minimize the side effects of treatment in children with Hodgkin disease (HD), chemotherapy was given without radiotherapy. PATIENTS AND METHODS From 1975 to 1984, 21 patients with HD having lymph nodes < 4 cm were treated with six MOPP courses. From 1984 to 1987, all children presenting with HD (n = 17) were given six ABVD courses. From 1987 to 1993 all children (n = 21) were treated with six alternating ABVD and MOPP courses. RESULTS MOPP-treated children showed an event-free survival (EFS) of 91%, overall survival, 100%; ABVD-treated children had an EFS of 70%, overall survival, 94%; ABVD-MOPP-treated children had an EFS of 91% and an overall survival of 91%. Two cases developed a second malignancy. Toxicity was low. CONCLUSIONS In children, ABVD-MOPP treatment gives a good survival, and toxicity is low. Radiotherapy is not needed to treat HD in children.