Long-term results of 60 patients with pathologic stage I & IIA Hodgkin's disease treated with exclusive mantle radiation therapy

Between January 1972 and December 1982 60 patients with pathological stage IA and IIA Hodgkin's disease (HD) were submitted to Mantle irradiation only . Twenty-five were in stage I (32.1%) and 35 in stage II (67.9%). All patie nts were submitted to staging laparotomy. Cases with large mediastinal mass were excluded from this series. Delivered doses were 44 Gy in involved are as, 40 Gy on the mediastinum and 36 Gy on uninvolved sites. Twenty-four pat ients in stage I (96%) and 33 in stage II (94.2%) obtained complete remissi on. Actuarial 10- and 20-yr overall (OS) rates were 86% and 79.1%, respecti vely. Event-free (EFS) and relapse-free (RFS) survival rates at 10 and 20 y r were 67.5% and 62.1%, respectively. The occurrence of disease relapse res ulted in the only statistical significant prognostic factor for OS in both univariate and multivariate analysis. Distant and extranodal recurrences we re significantly (P<0.01) related to a reduced OS. On multivariate analysis stage was the only determinant factor for increased RFS. Extended field RT proved to be an effective curative modality for stage I HD patients, where as 15 out of 33 patients in stage II relapsed requiring salvage therapy. Lo ng-term analysis of survival and treatment-related morbidity rates will imp rove our knowledge and assist the physicians to choose the therapeutic opti on to offer to HD patients.