title: [Pediatric Hodgkin disease in North Tunisia: clinical and therapeutic study].
abstract: OBJECTIVE
  To assess the epidemiological, clinical and therapeutic aspects of pediatric Hodgkin disease (HD) and to study prognosis factors.
  
  
  METHODS
  We retrospectively reviewed the medical records of children (≤18 years) with HD treated between 1st January 1994 and 31st December 2004. Chemotherapy was undertaken in different departments of hematology and oncology in the North of the country and radiotherapy was centralized at the Salah-Azaïz National Cancer Institute.
  
  
  RESULTS
  One hundred fourteen consecutively treated patients were collected. Median age was 12 years (4-18 years) and sex-ratio was 2.25. Peripheral lymphadenopathy was the predominant circumstance of HD detection (82.5%). The predominant histologic type was nodular sclerosing (56%). Treatment included chemotherapy and involved-field radiotherapy. With a mean follow-up of 23.5 months, relapse rate was 12.2%. Five-year overall survival (OS) and event-free survival (EFS) rates were 95% and 76%, respectively. Five-year OS was 98.2% and 90.8% for early and advanced stages respectively. In multivariate analysis, stage IV (P=0.029) and early response to initial treatment (P=0.003) retained statistical significance for EFS whereas the only prognostic factor for OS was stage IV (P=0.002). The long-term side effects were rare. No secondary tumor was noted.
  
  
  CONCLUSIONS
  Combined-modality therapy using chemotherapy and involved-field radiotherapy was effective and well-tolerated in early stage pediatric HD. Stage IV patients should be referred to specialized units for intensive treatment. The short median follow-up in our study cannot allow considering long-term effects.
authors.affiliation: Service radiothérapie, institut Salah-Azaiz, boulevard Bab-Saadoun, Tunis, Tunisie. lotfi.kochbati@yahoo.fr
authors.forename: L
authors.initials: L
authors.lastname: Kochbati
authors.forename: F
authors.initials: F
authors.lastname: Fdhila
authors.forename: I
authors.initials: I
authors.lastname: Belaid
authors.forename: H
authors.initials: H
authors.lastname: Rifi
authors.forename: S
authors.initials: S
authors.lastname: Barsaoui
authors.forename: N
authors.initials: N
authors.lastname: Ben Romdhane
authors.forename: Z
authors.initials: Z
authors.lastname: Bel Hadj Ali
authors.forename: A
authors.initials: A
authors.lastname: Mezlini
authors.forename: F
authors.initials: F
authors.lastname: Oubich
authors.forename: M
authors.initials: M
authors.lastname: Maalej
mesh_terms: D000293:Adolescent; D000741:Anemia, Aplastic / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced; D059248:Chemoradiotherapy; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006689:Hodgkin Disease / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage / Q000009:adverse effects; D017785:Photons / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011344:Procarbazine / Q000008:administration & dosage / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D007069:Ifosfamide; D011241:Prednisone