Treatment of stage I and II mediastinal Hodgkin disease. A comparison of involved fields, extended fields, and involved fields followed by MOPP in patients staged by laparotomy.
Three treatment programs for Stage I and II mediastinal Hodgkin disease (established by laparotomy) were compared. Involved-field radiotherapy + MOPP gave a disease-free survival rate of 97%, significantly different from 62% and 55% for involved and extended fields, respectively. Corresponding survival figures of 97%, 88%, and 84% were not significantly different statistically due to salvage with radiotherapy and/or chemotherapy. Among patients given radiotherapy alone, the survival figure of 94% for limited mediastinal disease was significantly better than 63% for extensive mediastinal and hilar disease; corresponding disease-free figures of 72% and 35% were also significantly different. Constitutional symptoms were an important prognostic factor in disease-free survival following the use of involved fields; hilar disease was important only with large mediastinal masses. Most relapses were intrathoracic; MOPP alone salvaged only 47%. Treatment of Stage I and II Hodgkin disease should be based on symptoms, extent of mediastinal disease, and hilar involvement.
D000971:Antineoplastic Combined Chemotherapy Protocols; D004359:Drug Therapy, Combination; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000627:therapeutic use*; D008479:Mediastinal Neoplasms / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use*; D011344:Procarbazine / Q000627:therapeutic use*; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D014750:Vincristine / Q000627:therapeutic use*
D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D011241:Prednisone