Long-term side effects in irradiated patients with Hodgkin's disease

Abstract

135 out of 168 patients with Hodgkin's disease in complete remission who had received radiotherapy with tumor doses between 3000 and 5000 rad in the years 1948–1974 were investigated with regard to long-term side effects. The results obtained so far are as follows: 1. 1. Catamnestic results: Deteriorated general condition and reduced performance in 23% and 28%, spontaneous restriction of the daily routine in 45% and increase in susceptibility to infections (common cold) in 15% of the patients 2. 2. Hematological investigations, (a) Peripheral blood: No indication of severe anemia. Granulocytopenia with less than 3000 cells/mm 3 in 18.5%, lymphocytopenia with less than 2000 cells/mm 3 in 37%, no incidence of thrombocytopenia with less than 100,000 platelets/mm 3 or leukemia. (b) Sternal marrow cytology (locally irradiated): Aplasia in 76%, hypoplasia in 18%. No signs of leukemia. (c) Iliac crest cytology (not directly irradiated): Slight hypoplasia in 38%, severe hypoplasia in 8%, no signs of leukemia. 3. 3. Pulmonary investigations: Slight paramediastinal fibrosis in 44%, distinct in 36% and severe in 9%. Restrictive ventilation disorder in 84%, increase in residual volume in 61%, O 2-diffusion disorder in 18% and obstructive ventilation disorder in 7% of the patients. 4. 4. Cardiological investigations: Under stress pulmonary hypertension in 18%, right ventricular function disorder in 9%, left ventricular function disorder in 9%, cardiac insufficiency in 2%, restriction of the maximum ergometer cycling exercise capacity in 53% of the patients. 5. 5. Thyroid function investigations: Hypothyroidal or latent hypothyroidal thyroid insufficiency in 16.5%. 6. 6. Neurological symptomatology (excluding herpes zoster): Slight to moderately severe double-sided cross section symptomatology in 3 of 122 patients (2.5%), bilateral or unilateral plexus paresis in 4 of 122 patients (3.5%). 7. 7. Genito-urinary tract ( male) investigations: Infertility (azoospermia, asemia, akinesis) following infradiaphragmatic irradiation using the inverted Y-method in 70%, restricted fertility (oligo-, astheno-, teratospermia) in 26% of the cases (in spite of the constant usage of a testicular capsule). 8. 8. Dermatological investigations: According to the number of patients, teleangiectasis, induration of the irradiated fields, and medium to severe irradiation discomfort occured in 22, 15.6 and 8% respectively.