In a clinical trial that involved 88 children with stage I or II Hodgkin lymphoma, Metzger and colleagues assessed the need for radiotherapy based on patients' early response to chemotherapy. All patients received 4 cycles of chemotherapy with vinblastine, doxorubicin, methotrexate, and prednisone. Patients who achieved a complete response after 2 chemotherapy cycles did not receive radiotherapy, whereas those with less than complete response did. The authors report that patients with a complete early response to chemotherapy and no subsequent radiotherapy had comparable 2-year event-free survival as patients who received radiotherapy. In an editorial, Whelan and Goldman discuss the evolution of Hodgkin lymphoma treatment in children.