title: Isolated parenchymal lung involvement in children with stage IV Hodgkin's disease: results of the UKCCSG HD8201 and HD9201 studies.
abstract: We retrospectively reviewed the case notes of 27 patients who were diagnosed with stage IV Hodgkin's disease (HD) because of isolated parenchymal pulmonary involvement on chest radiograph and computerized tomography scan (excluding subcategory E). Ten were boys and 15 had B symptoms. Median age at diagnosis was 13.6 years (range 6.1-16.2). All received 6-8 cycles of ChlVPP (chlorambucil, vinblastine, procarbazine and prednisolone) and two had additional whole lung irradiation (12 Gy). Ten patients (37%) relapsed or progressed. Seven survive following second-line therapy while three died, two of HD and one of secondary acute myeloid leukaemia 4 years from diagnosis. At the time of analysis, the median follow-up of patients was 56 months (range 9-127). The event-free survival (EFS) was 58.4% (95% CI 38.5-75.8%) at both 5 and 10 years from diagnosis, and the overall survival (OS) was 84.2% (95% CI 61.8-94.6%) at both 5 and 10 years from diagnosis. We conclude that the outcome for HD patients defined as stage IV, because of isolated parenchymal lung involvement, is encouraging and compares favourably with other extra lymphatic organ involvement. Combination chemotherapy is effective in achieving long-term remission and whole lung irradiation is unnecessary.
authors.affiliation: Department of Paediatrics, Riyadh Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia. ayadatra@hotmail.com
authors.forename: Ayad
authors.initials: A
authors.lastname: Atra
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Higgs
authors.forename: Michael
authors.initials: M
authors.lastname: Capra
authors.forename: Ann
authors.initials: A
authors.lastname: Elsworth
authors.forename: John
authors.initials: J
authors.lastname: Imeson
authors.forename: Martin
authors.initials: M
authors.lastname: Radford
authors.forename: Ross
authors.initials: R
authors.lastname: Pinkerton
authors.forename: M
authors.initials: M
authors.lastname: Hewitt
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed