Treatment of children and adolescents with Hodgkin’s Lymphoma without radiotherapy for patients in complete remission after chemotherapy

More than sixty years ago Hodgkin’s Lymphoma was considered a “systemic” malignancy and universally fatal. More recently less extensive radiation therapy in combination with chemotherapy has resulted in an excellent overall survival and prolonged disease free survival in children and adolescents. Unfortunately, the occurrence of radiotherapy-associated long terms adverse events such cardiovascular complications, infertility, endocrine disfunctions and secondary malignant neoplasia became of great concern. In the attempt to minimize the risk of these late effects, several international pediatric trials were organized to reply to the question: can radiotherapy be omitted with early stage Hodgkin’s Lymphoma in patients who achieved complete remission after chemotherapy alone?