Gehan E A, Sullivan M P, Fuller L M, Johnston J, Kennedy P, Fryer C, Gilchrist G S, Hays D M, Hanson W, Heller R
Pediatric Intergroup Statistical Center, Houston, Texas.
Cancer. 1990 Mar 15;65(6):1429-37. doi: 10.1002/1097-0142(19900315)65:6<1429::aid-cncr2820650630>3.0.co;2-b.
A total of 228 previously untreated and eligible children with pathologic Stage I or II Hodgkin's disease were registered in the Intergroup Study of Hodgkin's Disease in Children between February 1977 and April 1981. Patients were randomized in the Southwest Oncology Group (later the Pediatric Oncology Group [POG] to involved-field (IF) radiotherapy alone or IF radiotherapy followed by six courses of mechlorethamine, vincristine, prednisone, and procarbazine (MOPP) chemotherapy; patients in the Children's Cancer Study Group (CCSG) and Cancer and Leukemia Group B (CALGB) were randomized to receive extended-field (EF) radiotherapy or IF radiotherapy followed by six courses of MOPP. An estimated 97% of patients receiving IF + MOPP were relapse-free and surviving (RFS) at 5 years, which was significantly better than 41% for patients receiving IF alone; however there was essentially no overall difference in survival experience between groups. Patients in CCSG and CALGB receiving IF + MOPP had significantly superior RFS at 5 years than patients receiving EF. Survival rate was not different between these two groups, an estimated 93% of patients surviving 5 years or longer. Although patients were not randomized between IF or EF radiotherapy, they were similar with respect to patient characteristics. There was some statistical evidence that RFS was superior at 5 years for patients receiving EF than for IF; however, there was no evidence of a difference in survival experience. The percentages of patients with late effects of therapy were not significantly different by treatment. The most common types of late effects were endocrine dysfunction and impaired resistance to infection. Overall, the response rate to therapy for relapse patients was good, being 83% among all patients who relapsed. Patient characteristics related to poor prognosis were the presence of constitutional (B) symptoms (fever, night sweats, and weight loss) and poor performance status.
1977年2月至1981年4月期间，共有228名未经治疗且符合条件的病理I期或II期霍奇金病患儿登记参加儿童霍奇金病组间研究。患者被随机分配到西南肿瘤协作组（后来的儿科肿瘤协作组[POG]），接受单纯受累野（IF）放疗或IF放疗后进行六个疗程的氮芥、长春新碱、泼尼松和丙卡巴肼（MOPP）化疗；儿童癌症研究组（CCSG）和癌症与白血病B组（CALGB）的患者被随机分配接受扩大野（EF）放疗或IF放疗后进行六个疗程的MOPP。估计接受IF + MOPP治疗的患者5年无复发生存（RFS）率为97%，显著高于单纯接受IF治疗的患者的41%；然而，两组之间的总体生存经验基本没有差异。CCSG和CALGB中接受IF + MOPP治疗的患者5年RFS显著优于接受EF治疗的患者。这两组的生存率没有差异，估计93%的患者存活5年或更长时间。尽管患者没有在IF或EF放疗之间随机分组，但他们在患者特征方面相似。有一些统计证据表明，接受EF治疗的患者5年RFS优于接受IF治疗的患者；然而，没有证据表明生存经验存在差异。治疗晚期效应患者的百分比在不同治疗组之间没有显著差异。最常见的晚期效应类型是内分泌功能障碍和抗感染能力受损。总体而言，复发患者的治疗缓解率良好，所有复发患者中的缓解率为83%。与预后不良相关的患者特征是存在全身（B）症状（发热、盗汗和体重减轻）以及身体状况不佳。
