Year: 1978
Type: article
Abstract: Between April 1969, and December 1974, 216 successive surgically-staged IA-IIIB Hodgkin's disease patients were seen and treated at the Joint Center for Radiation Therapy. Patients with stages IA and IIA disease received mantle and para-aortic-splenic pedicle irradiation alone and have a probability of relapse-free survival of 97% and 80%, respectively. Patients with stage IIIA disease were treated with total-nodal irradiation (TNI) alone and have a 51% relapse-free and 82% overall survival. In spite of the high relapse rate in stage IIIA patients, the majority are currently disease-free following retreatment with MOPP chemotherapy. Stage IIB and IIIB patients received either radiation therapy alone or combined with chemotherapy. While the relapse-free survival is similar in stage IIB patients with or without the addition of chemotherapy, combined TNI and MOPP chemotherapy in stage IIIB patients has provided a superior relapse-free survival (74%) when compared to patients treated with TNI alone. There have been 3 mantle irradiation-related deaths in 209 patients treated (1.5%); in contrast, there have been 6 deaths related to combined-modality treatment in 74 patients at risk (8%). We continue to advocate the minimum therapy needed to produce uncomplicated cure. We feel that this is achieved with radiation therapy alone in stages IA and IIA disease without extensive mediastinal involvement and with combined modality therapy in stage IIIB disease. The role of combined modality therapy in place of radiation therapy alone in stage IIB and IIIA disease is less certain.
Source: Cancer
Authors: Samuel Hellman, Peter Mauch, Robert L. Goodman, David S. Rosenthal, William C. Moloney
Institution: Harvard University
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2085128973