[Questions concerning supplementary radiotherapy in patients with stage III or IV Hodgkin's disease in remission after chemotherapy].
The role of additional radiotherapy in the treatment of patients with advanced stages of Hodgkin's disease is still controversial. Additional radiotherapy is intended to eradicate any persistent disease to reduce recurrence rates and improve survival. The radiotherapy is applied to the lymph node stations or the organs affected at first presentation as most relapses after a chemotherapy-induced remission occur in previously involved sites of disease. Residual abnormalities on radiologic analysis after chemotherapy are present in the vast majority of the patients and a reliable method of separating active disease from fibrotic remnants is still lacking. Long-term toxicity data of combined chemotherapy and radiotherapy show an increased incidence of secondary malignancies and cardiac and pulmonary disease. Randomised studies are not conclusive as yet. Although, at least in subgroups of patients, the recurrence rates appear to decrease after additional low-dose involved-field radiotherapy, improvement of overall survival has not been demonstrated.
Raemaekers
J M
JM
Academisch Ziekenhuis, afd. Bloedziekten, Nijmegen.
D018572:Disease-Free Survival; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction