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Hodgkin's disease in children. A retrospective analysis: 1958-73
Insights
Survival rates for pediatric Hodgkin
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Research
Background:
- Hodgkin's disease in children presents unique treatment challenges.
- Long-term outcomes for pediatric Hodgkin's disease require continuous evaluation.
Purpose of the Study:
- To review treatment outcomes for children with Hodgkin's disease.
- To identify factors contributing to improved survival and relapse-free rates over time.
Main Methods:
- Retrospective review of 109 children with Hodgkin's disease treated between 1958-1973.
- Analysis of survival and relapse-free rates across different treatment eras.
- Correlation of outcomes with advancements in diagnostic and therapeutic modalities.
Main Results:
- Crude 5-year survival rates improved significantly: 50% (1958-64) to 95% (1969-73).
- 5-year relapse-free rates increased from 19% to 57% over the study period.
- Improvements coincided with the introduction of lymphography, laparotomy with splenectomy, extended field irradiation, and multi-agent chemotherapy.
Conclusions:
- Sequential advancements in diagnostic imaging, surgical staging, radiation therapy, and chemotherapy have dramatically improved outcomes for pediatric Hodgkin's disease.
- The integration of multi-agent chemotherapy, particularly in advanced stages, is crucial for enhancing survival and reducing relapse.
- This study highlights the importance of evolving treatment strategies in pediatric oncology.
Abstract:
One hundred nine children with Hodgkin's disease consecutively treated at The Princess Margaret Hospital, Toronto, during 1958-1973 are reviewed. Crude 5-year survival rates, regardless of stage, were 1958-64--50%; 1965-68--73%; and 1969-73--95%. The corresponding 5-year relapse-free rates were 19%, 20%, and 57%. This progressive improvement in results was associated with the sequential introduction of lymphography and laparotomy with splenectomy, the change from involved field to extended field irradiation, and the introduction of multiple agent chemotherapy, at first for generalized relapse and recently as elective initial therapy, combined with extended field irradiation for children in advanced stages.