Experience with a new technique for "total node" irradiation--Hodgkin's disease.

Abstract

Fifty-five patients with Hodgkin's disease, Stages III and IV, were treated by a new technique for total node irradiation. The so-called “3 and 2” method uses two courses of therapy: (1) All lymph-node bearing areas from the tips of the mastoid processes down to the femoral triangles, divided into three segments, are irradiated sequentially to 2,000 rads in four and a half weeks with no rest period between the segments irradiated. (2) After a rest period of three to fourweeks, the same lymphnode drainage areas are divided into two segments, and are irradiated to 1,800–2,000 rads in three and a half weeks. The juncture point is at a level different from the previous two juncture points. This minimizes the risk of overdosage and underdosage where portals abut. It is also often possible to reduce the field sizes, particularly the mediastinal portions, because of shrinkage of the masses during the rest period. The volume of normal tissue irradiated is thus reduced. Treatment was well tolerated. All patients showed complete response with prompt regression of nodes, symptoms and signs, and very little radiation-induced sickness. Blood counts remained within satisfactory limits throughout. There was prompt bone marrow recovery between courses thus avoiding interruptions in treatment.