Currently Viewing:
Newsroom
Currently Reading
Alemtuzumab Retained Long-Term Safety and Efficacy in Patients With Relapsing-Remitting Multiple Sclerosis of All Ages
June 15, 2019 – Wallace Stephens
Isatuximab Combination Improves PFS in Relapsed, Refractory MM
June 15, 2019 – Samantha DiGrande
Sensory Processing Difficulties Worsen Quality of Life in Children With Migraine
June 15, 2019 – AJMC Staff
Are Daily Corticosteroids Necessary for Mild Asthma? Recent Study Suggests Otherwise
June 14, 2019 – Samantha DiGrande
Exploring Oncology Financial Toxicity, Cost of Care
June 14, 2019 – AJMC Staff
Attending to Psychosocial Concerns for Those With Epidermolysis Bullosa
June 14, 2019 – AJMC Staff
5 Takeaways From the ADA Scientific Sessions
June 14, 2019 – Mary Caffrey
AJMC® in the Press, June 14, 2019
June 14, 2019 – AJMC Staff
This Week in Managed Care: June 14, 2019
June 14, 2019

Radiotherapy Plus Chemotherapy Improves Survival in Pediatric Patients With Hodgkin Lymphoma

Laura Joszt
Pediatric patients with early-stage Hodgkin lymphoma who are treated with chemotherapy followed by radiotherapy, known as combined modality therapy, have an improved 5-year survival rate compared with patients treated with chemotherapy alone.
Pediatric patients with early-stage Hodgkin lymphoma (HL) who are treated with chemotherapy followed by radiotherapy, known as combined modality therapy (CMT), have an improved 5-year survival rate compared with patients treated with chemotherapy alone, according to a study published in JAMA Oncology.

However, there has been a recent decrease in the use of combined modality because both chemotherapy and radiotherapy are associated with an increased risk of toxic effects. Late effects of radiotherapy include cardiopulmonary toxic effects and second malignant neoplasms.

“Nationwide, there has been a notable decrease in combined modality therapy, especially in clinical trials, many of which are designed to avoid this strategy,” Rahul Parikh, MD, a radiation oncologist at Rutgers Cancer Institute and the senior author of the work, said in a statement. “This form of treatment has shown to be effective with event-free survival rates greater than 80% and overall survival rates greater than 95%. The question then becomes, ‘does treatment benefit outweigh the risk of long-term side effects?’”

The study in JAMA Oncology sought to understand the use of CMT in pediatric patients with HL and the associated overall survival. The authors used data from the National Cancer Database and analyzed 5657 pediatric patients 21 years or younger with stage I or II classic HL. Approximately half (50.3%) received CMT.

The authors found male patients were more likely than females to receive CMT. Patients who received CMT were also more likely to be younger, more likely to have stage II disease, and more likely to have private insurance.

A total of 2845 patients received CMT and 2812 patients received chemotherapy alone. Use of CMT was associated with improvement in overall survival (OS). At 5 years, OS was 97.3% for patients receiving CMT and 94.5% for patients receiving chemotherapy alone.

According to Parikh, the findings should encourage physicians to discuss CMT as a treatment option at the time of diagnosis.

“Investigators may also consider designing future clinical trials for this population to include combined modality therapy as a standard arm with the inclusion of interim treatment response assessment (PET [positron emission tomography] scans, etc),” he added. “And as multiple disparities to the use of combined modality therapy have been identified through this work, future studies should address improving access to care for all pediatric patients.”

Reference

Jhawar SR, Rivera-Núñez Z, Drachtman R, Cole PD, Hoppe BS, Parikh RR. Association of combined modality therapy vs chemotherapy alone with overall survival in early-stage pediatric hodgkin lymphoma [published online January 03, 2019]. JAMA Oncol. doi: 10.1001/jamaoncol.2018.5911.

 
Copyright AJMC 2006-2019 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up