Early-stage Hodgkin's disease.
Treatment of Hodgkin's disease (HD) is strictly dependent on stage. Historically, early-stage HD included the limited stages I, II, and IIIA (according to the Cotswolds modification of the Ann Arbor classsification), whereas advanced HD included stage III with B symptoms and stage IV. It was then observed that early-stage HD with certain clinical risk factors had a significantly worse outcome. As a consequence, several studies defined these patients as suffering from early-stage unfavorable (or intermediate-stage) HD, demanding a more aggressive treatment. The treatment of early-stage HD is changing strikingly. Until recently, extended-field (EF) irradiation has been considered the standard treatment. However, because of the recognition of its high relapse rate and fatal long-term effects, EF radiotherapy is now being abandoned by most study groups. Instead, for favorable early-stage HD, mild chemotherapy for control of occult disease is combined with involved-field (IF) irradiation. In early-stage unfavorable (intermediate) HD, four cycles of chemotherapy plus IF irradiation is accepted as standard treatment.
Josting
A
A
First Department of Internal Medicine, University Hospital Cologne, Joseph-Stelzmann-Str. 9, 50924 Cologne, Germany.
Diehl
V
V
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006689:Hodgkin Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis; D012008:Recurrence