Pilot results of combined therapy of recurrent and refractory forms of Hodgkin's disease (polychemotherapy, radiotherapy, removal of residual mediastinal mass)

Aim, To achieve a maximal complete remission rate in patients,vith recurren t and refractory Hodgkin's disease. To find out a group of patients in whom surgical removal of the residual mediastinal mass would be most effective. Material and methods. 46 patients with Hodgkin's disease received Dexa-BEAM chemotherapy followed by radiotherapy. Surgical removal of the residual me diastinal mass was made in 12 patients. Results. Second-line Dexa-BEAM therapy produced a 50% complete, emission ra te. Overall survival was 45.5%, the disease-free survival - 43.5%. Removed mediastinal masses were indicative of Hodgkin's disease in 7 cases and fibr osis in 4 cases. Conclusion, Dexa-BEAM is an effective program in the treatment of recurrent and refractory Hodgkin's disease. Surgical removal of the residual mediast inal mass with radiotherapy and high-dose chemotherapy improves prognosis i n very unfavorable, primary progressive form of Hodgkin's disease.