Radiotherapy may be omitted in children and adolescents with classical Hodgkin lymphoma in complete remission after frontline risk and response-adapted chemotherapy: a multicenter clinical trial (LH-GALOP 2017)

A multicentre, prospective, risk and response adapted treatment for newly diagnosed paediatric classical Hodgkin Lymphoma was carried out to avoid radiotherapy (RT) when complete remission (CR) was achieved after chemotherapy. Three risk groups were initially defined. Chemotherapy combined ABVD and ESHAP regimes. CR was defined by Deauville Score 80% CT volume reduction. Patients in CR after completing chemotherapy did not receive RT, those in partial remission received involved site RT (30 Gy). Refractory disease was considered a trial failure. From October 2017 to November 2024, 109 assessable patients were recruited, M/F = 1.8, median age 11.9 (r = 3–16.8) years. Low risk = 18%, Intermediate risk = 30%, High risk = 51%. CR after chemotherapy was obtained in 94 patients (86.2%). Radiotherapy was delivered in 19.3% of patients, including cases in partial remission, relapse, and refractory disease. With a median follow up of 58 months, at 5 years, EFSp was 88.5% (SE = 3%) and OS, 100%.