Stage IA to IIB mediastinal Hodgkin's disease: three-dimensional volumetric assessment of response to treatment.
From 1979 to 1986, the response to treatment of 53 patients with stage IA to IIB mediastinal Hodgkin's disease was evaluated by three-dimensional volumetric analysis using thoracic computed tomographic (CT) scans. The mean initial volume of mediastinal disease in 34 patients treated with mantle and para-aortic irradiation was 166 mL, whereas for 19 patients treated with two to six cycles of multiagent chemotherapy and mantle and para-aortic irradiation the mean initial volume was 446 mL. Preliminary data suggested that patients with mediastinal volumes of less than 200 mL had a lower mediastinal relapse rate (13%) than patients with volumes greater than 200 mL (32%). For 12 patients receiving six cycles of nitrogen mustard, vincristine, procarbazine, and prednisone (MOPP), those with a greater than 85% reduction in volume 1 to 2 months after chemotherapy had a lower incidence of mediastinal relapse (zero of six, 0%) compared with patients having 85% or less reduction in volume (four of six, 67%). The primary value of this technique is that it provides a sensitive assessment of response to treatment and may aid in monitoring the effectiveness of a given treatment.
Willett
C G
CG
Department of Radiation Medicine, Massachusetts General Hospital Cancer Center, Boston.
Linggood
R M
RM
Leong
J C
JC
Miketic
L M
LM
Stracher
M A
MA
Skates
S J
SJ
Kushner
D C
DC
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006689:Hodgkin Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000627:therapeutic use; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D011344:Procarbazine / Q000627:therapeutic use; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000627:therapeutic use
D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D011241:Prednisone