Abstract
A comprehensive survey of late effects (physical, social and reproductive) following treatment at a single institution for early stage Hodgkin's disease (HD) was performed. A total of 611 patients with stage I and II HD treated between 1973 and 1984 were reviewed; 460 were alive and were mailed a self-reported questionnaire. A total of 363 (79%) replies were received. Twenty patients died of second malignancy, 14 of heart disease and nine from respiratory disease. There were 37 cases of second malignancy [relative risk (RR) 2.2, absolute excess risk (AR) 35.8]. The 15-year incidence of heart disease was 11% and there were nine myocardial infarction deaths (RR 1.55, AR 5.4). Twenty-eight (8%) respondents stated that their career had been greatly interfered with, 53 (14.5%) perceived financial loss. Sexual activity was disrupted in 25.8%. In total, 56 men had fathered 112 pregnancies. Of 171 women, 40.3% became pregnant, resulting in 92 live births. A total of 43 men and 16 women had sought medical advice with regard to infertility.
Highlights
We report our experience with late morbidity associated with treatment of early stage Hodgkin's disease (HD) at the Princess Margaret Hospital (PMH)
This study reports the results of an extensive review of late effects of treatment of a consecutive group of patients with stage I and II HD treated at a single institution
The largest analysis of second malignancy was conducted by the International DataBase on Hodgkin's Disease (IDHD) (Henry-Amar, 1992) which includes the patients in the current study
Summary
The study population for this report comprised all patients with stage I and II Hodgkin's disease treated at the PMH between 1973 and 1984. Extended field radiation was delivered to 245 patients (41.2%) and consisted of a mantle field followed by upper abdominal irradiation to the para-aortic lymph nodes and spleen after a 4-week interval. A total of 246 patients (41.5%) received mantle radiation or inverted Y radiation for infradiaphragmatic disease, and 103 patients (17.3%) received involved field radiation only. A total of 230 patients (37.6%) were treated with one field a day. The usual radiation dose and fractionation schedule was 3500 cGy given in 20 daily treatments over 28 days, delivered by a cobalt unit with extended SSD. A total of 357 (60.1%) patients received 3500 cGy in 20 fractions.
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