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Matthew J. Krasin, MD
The combination of chemotherapy and irradiation provides excellent local control of Hodgkin disease (HD) in children and young adults, according to results of two prospective studies at St. Jude. In addition, when HD recurs, it does so primarily at the initial site of treatment—that is, local failure—rather than at distant sites, the researchers reported. And the factors that predict local failure include male gender, low initial levels of hemoglobin and a bulky disease in the mediastinum—the part of the body between the lungs. A report on these findings appears in the November 20 issue of Journal of Clinical Oncology.
The St. Jude investigators enrolled 195 patients into two prospective studies between 1990 and 2000 and treated them with both chemotherapy and radiation that was delivered to the initial site of disease. The cumulative incidence of local failure during a median follow-up of 7.6 years was 10.9 percent at five years and 11.6 percent at 10 years.
“Analyzing sites of failure and factors associated with failure has helped us better tailor our therapy for individual children,” said Matthew Krasin, MD, Radiological Sciences, first author of the paper.
“In the future we might be able to further improve treatment outcomes by incorporating the use of functional imaging (positron emission tomography) to determine response to treatment, and by noting biological differences in the disease among patients,” said Melissa Hudson, MD, Hematology-Oncology, co-author of the paper.
Other authors of the paper include Shesh Rai, PhD, Biostatistics; Scott Howard, MD, International Outreach; Monika Metzger, MD, Hematology- Oncology; and Sue Kaste, DO, Larry Kun, MD, and Thomas Merchant, DO, PhD, Radiological Sciences.
Last update: February 2006