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Abstract Treating Hodgkin lymphoma (HL) among children involves a tradeoff between cure and reducing long term radiotherapy toxicity like secondary malignancies, cardiac and endocrine dysfunction. Fluorodeoxyglucose positron emission tomography (PET) combined with computed tomography (CT) identifies patients with early response to chemotherapy, for whom radiotherapy may be avoided. The prognostic role of PET-CT in response–adapted treatment is evaluated in this study. This study was aiming for discussing the role of FDG-PET/CT scan as a prognostic value of interim (after two cycles of chemotherapy OEPA) and end of treatment in pediatric Hodgkin’s Disease in terms of event free survival and overall survival. Patients with HL of all treatment groups, who were younger than 18 years, were included. Interim PET-CT was performed after two chemotherapy cycles. Patients were stratified into three risk groups: group 1 (stage I or II with no unfavorable features); group 2 (stage I or II with bulky disease/B symptoms); and group 3 (stage III/IV). A vincristine, etoposide, prednisone and doxorubicin –based regimen was used in early disease. A Cyclophosphamide, Oncovin, Predinsone, Dacarbazine–based regimen was used in advanced disease. Patients who achieved complete response by interim PET-CT will avoid radiotherapy. Sixty-five patients were included. Sixteen (24.6%), 27 (41.5%), and 22 (33.9%) patients were included in treatment groups 1, 2, and 3, respectively. On the basis of negative interim PET responses, 43 (66.1%) patients were treated without radiotherapy. The 5-year event-free survival for the entire cohort was 89 % and overall survival was 97%. Most of the PET-CT scans at the end of treatment were done in positive interim PET-CT cases, while in early responders; only CT scans were done. |