Hodgkinʼs disease

Abstract

From January 1965 to December 1975, 122 patients diagnosed with Hodgkin's disease, Stage I-A, II-A, and III-A were treated at the Department of Radiation Therapy at Hahnemann Medical College and Hospital. Twenty-five patients with Stage I-A, 54 patients with Stage II-A, and 43 patients with Stage III-A were accepted for treatment. Retrospective analysis was made to define the impact of the cell type, clinical and pathologic stage, and tumor bulk on prognosis. Of the 25 patients with Stage I-A Hodgkin's disease, 13 were clinically staged and 12 pathologically staged. Nine patients received extended-field radiation therapy with the overall relapse-free survival of 100% at 5 and 9 years; 16 patients received mantle radiation only, with overall survival of 84% and relapse-free survival of 68% at 5 and 10 years. Of 54 patients with Stage II-A Hodgkin's disease (32 clinically staged and 22 pathologically staged), six patients received involved field radiation therapy with overall survival of 68 and 49% at 5 and 10 years, and relapse-free survival of 33 and 17% at 5 and 10 years. Nineteen patients received limited-field radiation therapy (mantle or inverted Y) with overall survival of 49% at 5 and 10 years, and relapse-free survival of 42 and 31% at 5 and 10 years, and 29 patients received extended-field radiation therapy (mantle and para-aortic or TNI) with overall survival of 88% at 5 and 10 years, and relapse-free survival of 82 and 73% at 5 and 10 years. The overall and relapse-free survival at 5 and 10 years in 22 patients pathologically staged II-A (treated by different techniques) are 95 and 75%. Forty-three patients with Stage III-A Hodgkin's disease (treated with different techniques) reveal an overall survival of 79 and 64% at 5 and 10 years, and relapse-free survival of 58 and 45% at 5 and 10 years. Complications consisted of six patients with overt symptoms of hypothyroidism, two patients with peripheral neuropathy, one patient with radiation myelitis, and two patients with symptoms of leukoencephalopathy. Two patients developed second malignancies.