Treatment of Hodgkin's disease: Current strategies of the German Hodgkin'sLymphoma Study Group

At present over 90% of early stage Hodgkin's disease patients will be cured . Both radiotherapy and combination chemotherapy are effective treatment mo dalities. However, the optimal choice of treatment or combinations of treat ment is still debated. Recently, several trials reported excellent treatmen t results with combined modality in early stages of Hodgkin's disease. The use of chemotherapy regimen not including alkylating agents may avoid the r isk of infertility and secondary malignancies and facilitates reduction of dose and field size of radiotherapy in early stages. In intermediate stages new chemotherapy regimen (i.e., BEACOPP) will offer the chance to reduce t he fraction of patients with initial treatment failure, while reducing the extent of radiotherapy. With the introduction of the escalated BEACOPP regi men it was demonstrated that the prognosis of the advanced stages could be positively influenced by intensification of therapy. Future trials aim to answer: 1) which chemotherapy regimen in which quantit y will be the best with respect to efficacy and longterm toxicity and 2) wh ich dose and field size of radiotherapy is adequate within the combined mod ality approach.