Omission of radiotherapy in children and adolescents with classical Hodgkin lymphoma and adequate response to OEPA

Children and adolescents with early-stage classical Hodgkin lymphoma (cHL) have a 5-year event-free survival rate of 90% or more with vincristine, etoposide, prednisone, and doxorubicin (OEPA) plus radiotherapy, but late complications of the treatment affect survival and quality of life. The EuroNet-PHL-C1 trial, at 186 centers across 16 European countries, investigated whether radiotherapy can be safely omitted in patients with adequate response to OEPA. Patients aged younger than 18 years received two cycles of OEPA, and only patients with inadequate morphologic and PET response to OEPA received involved-field radiotherapy.The 5-year event-free survival was 86.5% in the group with adequate OEPA response and no radiotherapy versus 88.6% in the group with inadequate OEPA response and radiotherapy. The authors conclude that radiotherapy could be omitted in children and adolescents with early-stage cHL and adequate response to OEPA.