Stage IA Hodgkin's Disease Research Articles

Long-term results of a prospective trial of mantle irradiation alone for early-stage Hodgkin's disease

To determine the long-term treatment outcome and late effects of mantle irradiation alone in selected patients with early-stage Hodgkin's disease. Between 1988 and 2000, 87 patients with pathologic stage (Ann Arbor) I-IIA or clinical stage IA Hodgkin's disease were entered on to a prospective trial of mantle irradiation alone. Patients with B symptoms, large mediastinal adenopathy, or subcarinal or hilar involvement were excluded. The median doses to the mantle field and mediastinum were 36 Gy (range 30.3-40) and 38.6 Gy (range 30.6-44), respectively. The actuarial freedom from treatment failure (FFTF) and overall survival (OS) rates were calculated using the Kaplan-Meier technique. The median follow-up was 107 months (range 23-192). Thirteen of 87 patients (15%) relapsed at a median of 30 months (range 5-62). The 5- and 10-year actuarial FFTF rates were 86% and 84.7%, respectively. All 13 patients who relapsed are alive without evidence of disease at a median of 84 months (range 30-156) post-salvage therapy. Five patients developed a second malignancy at a median of 93 months (range 27-131). The 10-year actuarial risk of a second malignancy was 4.5%. There have been two deaths to date, both due to second malignancies. The 10-year OS rate was 98.2%. In selected patients with early-stage Hodgkin's disease, mantle irradiation alone has an excellent long-term survival rate, comparing favorably with the previous standard treatment of extended-field radiation therapy and the current standard of combined modality therapy.

ACUTE MYELOID LEUKEMIA FOLLOWING THERAPY OF HODGKIN'S DISEASE WITH RADIOTHERAPY AND ABVD (DOXORUBICIN, BLEOMYCIN, VINBLASTINE, AND DACARBAZINE)

A 26-year-old man developed myelodysplasia rapidly progressing to acute myelomonocytic leukemia 3 years after receiving three cycles of ABVD chemotherapy and upper mantle and upper abdomen radiotherapy for stage IA Hodgkin's disease. This represents the fourth such case reported. The risk of secondary AML after ABVD or radiation therapy is discussed.

Case report: Benign thymic cyst following mantle radiotherapy for Hodgkin's disease

The case history of a patient who was treated for Stage IA Hodgkin's disease involving the left supraclavicular region is presented. Shortly after mantle field radiation therapy she developed a mass in the anterior mediastinum. Histological examination of the lesion revealed it to be a benign cyst of the thymus. We consider it important that the possibility of the existence of such a benign growth be considered when a mediastinal mass appears in a patient treated for Hodgkin's disease, before more intensive tumour therapy is given.