Radiotherapy of early stages Hodgkin's disease. 10 years experience of theMasaryk Memorial Cancer Institute

Radiotherapy and chemotherapy, alone or in combination, are curative treatm ent methods in early stages of Hodgkin's disease (HD). The choice of treatm ent depends on the stage of the disease, histological type and localization of the tumor, as well as on other prognostic factors. A retrospective stud y was conducted including 145 patients with clinical Stages I and II of HD according to Ann Arbor classification, all treated in the Masaryk Memorial Cancer Institute in Brno during the years 1985 through 1994. 80 patients we re males (55%) and 65 patients females (45%). The age of the patients range d from 1 I to 77 years, with an average of 34.8 years. 41 patients were dia gnosed with Stage IA tumor, 1 patient with Stage IB, 75 patients with Stage IIA and 28 with Stage IIB disease. The histological types of the disease w ere lymphocyte predominant in 23 patients, nodular sclerosis in 49 patients , mixed cellularity in 65 cases and lymphocyte depletion in 8 cases. 91 patients were treated with radiotherapy alone. In this group 14 patients relapsed within the radiation field (15%) and 25 outside the radiation fie ld (28%). 39 patients were treated with combination of radiotherapy and che motherapy. In this group relapse occurred within the radiation field in 3 p atients (8%) and outside the radiation field in 7 patients (18%). 15 patien ts were given chemotherapy alone, 7 patients from this group experienced a relapse. The five-year survival was 81% in patients with Stages IA and IIA disease, 65% in Stages IB and IIB disease. The five-year survival in the patients wh o relapsed was 56%. Radiotherapy remains the curative method of choice in highly selected group of patients with early stages of Hodgkin's disease. The results of radioth erapy alone are unsatisfactory in unselected clinical Stage I-II patients b ecause of the presence of patients with adverse prognostic factors, particu larly B symptomatology, mixed cellularity/lymphocyte depletion histology, h igher age. These patients are candidates for combined treatment. Modern equ ipment and meticulous treatment are conditions crucial for the outcome of c urative radiotherapy in patients with Hodgkin's disease. Combination chemotherapy is very effective in the treatment of relapse foll owing the primary radiotherapy.