The place of radiotherapy in the management of localised Hodgkin's disease (Report no 11).
This report reviews the experience of the BNLI in managing localised Hodgkin's disease, since the BNLI began in February 1970. The original problem investigated by this study was the evaluation of 'prophylactic' irradiation treating adjacent apparently unaffected regions, as opposed to radiation directed to only the affected regions of the body. Because lower half Hodgkin's disease is uncommon, the study was confined to patients presenting with upper half disease, without 'B' symptoms. Diagnostic laparotomy and splenectomy was not considered to be a mandatory investigation and at the commencement of the study was recommended by only two collaborators. By the completion of the study the majority of collaborators were recommending this procedure routinely. This study therefore includes two additional subgroups of patients with Stages I, IIA (upper half) Hodgkin's disease. In the laparotomised group of patients a 10-year survival rate of almost 95% with either 'local' or 'prophylactic' irradiation suggests that wide field irradiation (including total nodal irradiation) is not essential in the cure of apparently localised Stages I, IIA (upper half) Hodgkin's disease, provided the extent of the disease has been accurately determined by previous investigation. In those patients treated with strictly 'localised' (as opposed to 'prophylactic') irradiation, relapses in adjacent unirradiated regions have been completely controlled by additional treatment, usually irradiation, and none have died of Hodgkin's disease.
D006689:Hodgkin Disease / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D007813:Laparotomy; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging