Purpose/Objective: From 1999 to 2003 43 pediatric cases of Hodgkin Lymphoma who were diagnosed in three pediatric centers of Izmir were treated with a modified version of German GPOH-HD95 study where low dose irradiation was used. Early results are presented here. Materials/Methods: Patients were grouped into 3 categories as TG-1 (IA/B,IIA), TG-2 (IIEA,IIB,IIIA) ve TG-3 (IIEB,IIIEA/B,IIIB,IVA/B) and treated with TG-1 2xOPPA (cyclophosfamide, vincrystine, procarbazine, prednisone) for TG-1, 2xOPPA+2xCOPP for TG-2 and 2xOPPA+4xCOPP for TG-3. Etoposide was used in boys instead of procarbazine (OEPA). Although chemotherapy was given in 3 different centers staging and response evaluation was done in joint meetings and irradiation was performed in the same center. Chemotherapy was same as HD95 study, however indications of irradiation and treatment fields were modified. Complete responders and those with more than 75% reduction in tumor size were irradiated to 20 Gy, those with less than 75% reduction were treated with 25-30 Gy and those with more than 50 cc tumor at the end of chemotherapy were treated with 35 Gy. Results: Three patients discontinued treatment due to several reasons, so the analysis was done for 40 patients. 33 of them were male and 7 of them were female, where median age was 9 (6-13). Histology was mixt cellular in 21, nodular sclerosan in 15, lymphocyte predominant in 3 and lymphocyte depleted in 1. There were 11 patients in group TG-1, 12 in TG-2 and 17 in TG-3. In 12 patients there was complete response to chemotherapy (30%) whereas partial response was noted in all others. Median follow-up was 36 months (6-59). Recurrence was developed in 7 patients (infield relapse in 1, other side of diaphragm in 2, same side of diaphragm in 1, bone marrow in 2 and distant organ relapse in 1). One patient died due to bone marrow involvement. The overall survival is 97% and DFS is 72% in 3-years. DFS is worse in advanced stage TG-3 patients (TG-1:91%, TG-2:86% and TG-3 45%; p=0.07). Other patient and treatment parameters did not have an effect on overall survival and DFS. Conclusions: Although relapse rate was higher than expected in TG-3 group, overall results show that treatment success is similar to our previous protocols where higher radiation doses were used
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