Chemotherapy and radiotherapy in Hodgkin's lymphoma: joining in or splitting up?
OBJECTIVE
Radiotherapy is very effective in local control of Hodgkin's lymphoma. Unfortunately, long-term survivors exhibit an excess of life-threatening radiation-related late side effects. Consequently, there have been calls to cease the use of radiation in the primary treatment of Hodgkin's lymphoma, although there is also support for the judicious use of combined modality treatment.


RESULTS
Most patients treated for Hodgkin's lymphoma are being cured with modern approaches. Recent publications confirm the superior efficacy of combined modality treatment over chemotherapy alone, but the initial gain in cure rate may be outweighed by late deaths due to various treatment-related diseases. Many patients may already be cured by chemotherapy alone. Classical risk factors can be used to distinguish favourable and unfavourable subgroups of patients with Hodgkin's lymphoma, but these risk factors cannot predict outcome in individual cases. A simple test to predict the likelihood of cure in individual patients would be of great benefit. Fluoro-deoxyglucose-PET scan investigation holds this promise.


CONCLUSIONS
The present review deals with the role of radiation therapy in the treatment of Hodgkin's lymphoma.
van der Maazen
Richard W M
RW
Department of Radiation Oncology, The Netherlands.
Raemaekers
John M M
JM
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans