Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, Maryland.
Pediatr Blood Cancer. 2014 Jul;61(7):1305-12. doi: 10.1002/pbc.24983. Epub 2014 Feb 24.
Pediatric Hodgkin lymphoma is a highly curable malignancy and potential long-term effects of therapy need to be considered in optimizing clinical care. An expert panel was convened to reach consensus on the most appropriate approach to evaluation and treatment of pediatric Hodgkin lymphoma. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Four clinical variants were developed to assess common clinical scenarios and render recommendations for evaluation and treatment approaches to pediatric Hodgkin lymphoma. We provide a summary of the literature as well as numerical ratings with commentary. By combining available data in published literature and expert medical opinion, we present a consensus to the approach for management of pediatric Hodgkin lymphoma.
儿童霍奇金淋巴瘤是一种高度可治愈的恶性肿瘤,需要在优化临床护理时考虑治疗的潜在长期影响。一个专家小组被召集来就评估和治疗儿童霍奇金淋巴瘤的最适当方法达成共识。美国放射学院适宜性标准是针对特定临床情况的循证指南,每 2 年由一个多学科专家小组进行审查。指南的制定和审查包括对同行评议期刊的现有医学文献进行广泛分析,并应用成熟的共识方法(改良 Delphi 法)对小组进行成像和治疗程序的适宜性进行评分。在缺乏证据或证据不明确的情况下,可以使用专家意见来推荐成像或治疗。制定了四个临床变异体来评估常见的临床情况,并为儿童霍奇金淋巴瘤的评估和治疗方法提出建议。我们提供文献综述以及带有评论的数值评分。通过结合发表文献中的现有数据和专家医学意见,我们提出了一种共识,即管理儿童霍奇金淋巴瘤的方法。