A discourse: The 2002 Wataru W. Sutow lecture Hodgkin disease in children—perspectives and progress†
Sarah S. Donaldson MD,
Corresponding Author
Sarah S. Donaldson MD
Department of Radiation Oncology, Stanford University Medical Center, Stanford, California
Department of Radiation Oncology, Stanford University Medical Center, 300 Pasteur Drive, Room A-083, Stanford, CA 94305-5302.Search for more papers by this authorSarah S. Donaldson MD,
Corresponding Author
Sarah S. Donaldson MD
Department of Radiation Oncology, Stanford University Medical Center, Stanford, California
Department of Radiation Oncology, Stanford University Medical Center, 300 Pasteur Drive, Room A-083, Stanford, CA 94305-5302.Search for more papers by this author†
Presented at: M. D. Anderson Cancer Center on March 14, 2002.
Portions of this discourse are published in the critical review “Pediatric Hodgkin's Disease—Up, Up, and Beyond” Int J Radiat Oncol Biol Phys, 2002, Elsevier Science, New York.
Abstract
The Pioneer
Wataru W. Sutow, 1912–1981, was a remarkable and pivotal leader in pediatric oncology. Early in his medical career, he conducted important clinical and anthropometric studies among Japanese and Marshall Island children exposed to atomic radiation. These studies established standards for childhood growth and development still in use today. Dr. Sutow pioneered the multidisciplinary approach to childhood cancer by combining multidrug chemotherapy protocols with surgery and radiotherapy in the common childhood solid tumors. The textbook “Clinical Pediatric Oncology,” of which he was the senior editor, served to define the discipline of pediatric oncology and educate a new era of oncologists in the curative treatment for childhood cancer.
The Past and Present
The first edition of “Clinical Pediatric Oncology,” published in 1973, demonstrated that only children with early-stage localized Hodgkin disease had a realistic opportunity for cure. Soon the use of combined-modality therapy consisting of low-dose, involved-field radiation plus multi-agent chemotherapy emerged, and made the goal of cure realistic for all patients. This approach is now universal. Today, the 5-year relative survival rate for American children with Hodgkin disease, who are under 14 years of age, is 94%, a dramatic and remarkable achievement.
Future
Management of children with Hodgkin disease now involves clinical staging and risk-adapted, combined-modality therapy. Clinical and translational research initiatives that hold promise for children with Hodgkin disease in the future include: use of the WHO Classification System combining morphologic and biologic criteria; noninvasive staging procedures with increased sensitivity and specificity; development of a useful prognostic index to define groups for risk-adapted therapy; high-dose therapy with stem cell transplantation; and novel therapies. Med Pediatr Oncol 2003;40:73–81. © 2003 Wiley-Liss, Inc.
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