{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T01:28:49Z","timestamp":1769045329730,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The InPOG\u2010HL\u201015\u201001, a multicentric prospective study, used a risk\u2010stratified and response\u2010based approach with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) backbone to treat children and adolescents with newly diagnosed Hodgkin lymphoma (HL) and reduce the use of radiation therapy (RT). Children\/adolescents with bulky disease or inadequate response at early response assessment (ERA) after two cycles of chemotherapy were assigned to receive RT. For ERA, positron emission tomography computed tomography (PET\u2010CT) was recommended but not mandatory in view of limited access. This study aimed to compare the impact of using contrast\u2010enhanced computed tomography (CECT) and PET\u2010CT on treatment decisions and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>396 patients were enrolled and 382 had an ERA at the assigned time point. Satisfactory response was defined as Deauville score 3 or less for patients undergoing PET\u2010CT and complete response (CR)\/very good partial response (VGPR) for patients undergoing CECT. Outcomes of interest incorporate 5 year event\u2010free survival (EFS), EFS including abandonment (EFSa), and overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At ERA, satisfactory response was documented in 277 out of 382 (72.5%) participants and this was significantly higher in PET\u2010CT (151 out of 186, 81.2%) as compared with CECT\u2010based assessments (126 out of 196, 64.3%) respectively (<jats:italic>p<\/jats:italic> value\u00a0&lt;\u00a0.001). Amongst the 203 patients with nonbulky disease (wherein the indication for RT was entirely dependent on ERA), 96 out of 114 (84.2%) and 61 out of 89 (68.5%) patients achieved a satisfactory response according to the PET\u2010CT and CECT (<jats:italic>p<\/jats:italic> value\u00a0=\u00a0.008) respectively and hence a lesser proportion of patients in the PET\u2010CT arm received RT. Despite a lower usage of RT the 5 year OS of both groups, ERA based on CECT (91.8%) versus PET\u2010CT (94.1%) was comparable (<jats:italic>p<\/jats:italic> value\u00a0=\u00a0.391) and so was the 5 year EFS (86.7\u00a0vs. 85.5%, <jats:italic>p<\/jats:italic> value\u00a0=\u00a0.724).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Use of PET\u2010CT as the modality for ERA is more likely to indicate a satisfactory response as compared with CECT and thereby decreases the need for RT in response\u2010based treatment algorithm for HL\u2010afflicted children. The reduction in the application of RT did not impact the overall outcome and plausibly would lower the risk of delayed toxic effects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30091","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T03:48:31Z","timestamp":1669088911000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Response assessment by positron emission tomography\u2010computed tomography as compared with contrast\u2010enhanced computed tomography in childhood Hodgkin lymphoma can reduce the need for radiotherapy in low\u2010 and middle\u2010income countries"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2570-7750","authenticated-orcid":false,"given":"Manas","family":"Kalra","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology Oncology BMT Sir Ganga Ram Hospital  New Delhi 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George's Medical University  Lucknow India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1808-1403","authenticated-orcid":false,"given":"Sandeep","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Rajiv Gandhi Cancer Institute  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Cancer Institute, Adyar  Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2625-7598","authenticated-orcid":false,"given":"Piali","family":"Mandal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kalawati Saran Children's Hospital  New Delhi 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