[Hodgkin's disease in stages I and IIA. Analysis of results in a group of patients with a follow-up of at least 10 years treated at the onset of the disease with radiotherapy alone]

Abstract

January, 1972, through December, 1982, ninety-four patients with Hodgkin's disease in stages I and IIA were treated in the Dept. of Radiation Oncology of the University "La Sapienza", Rome. All patients had a minimum follow-up of 10 years. After careful clinical and surgical examinations comprehensive of laparosplenectomy, all patients were submitted to extended field radiation treatment. Ninety-one of 94 patients (97%) obtained complete remission. Overall survival at 10 years was 91% and independent of stage (94% in stage I and 87% in stage II), while relapse-free survival at 10 years did depend on stage (83% in stage I and 49% in stage II); the difference was statistically significant (p < 0.01). Thirty-one of 94 patients relapsed, but fortunately 94% of them obtained a second complete remission after salvage chemotherapy. Our experience confirms the low tumorigenic potential of exclusive radiation therapy; only one of 4 secondary neoplasms (acute non-lymphatic leukemia) observed in this series had been treated with radiotherapy. The results of this study confirm the efficacy of exclusive irradiation in stage I patients, while treatment approach remains debated in stage II patients. The combination of short-time chemotherapy with curative irradiation is probably the best option to reduce both the incidence of recurrences and treatment-induced complications.