Abstract
We radiotherapists are historically conditioned to approach the treatment of neoplasms in a surgical spirit: our standard of success is the five-year ie, the eradication of unifocal disease. Most of the confusion with regard to the lymphomas, I believe, may be traced to this basic mode of thinking. These lymphomas cannot be viewed this way. They represent systemic diseases (with the possible exception of some lymphosarcomas, eg, tonsil, nasopharynx, stomach, ileocecal region); the approach should not be guided by the surgical aim of cure, but by the internist's aim of providing enjoyable life. The more regular use of sophisticated diagnostic evaluation (lymphogram, abdominal exploration, splenectomy) has shown that the overwhelming majority of patients (70%) are in stage III when first seen, supporting the assumption that Hodgkin's disease is a systemic disease. The treatment of advanced disease thus becomes more and more important from the point of view of prognosis
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