title: Long-term results of a prospective trial of mantle irradiation alone for early-stage Hodgkin's disease.
abstract: BACKGROUND
  To determine the long-term treatment outcome and late effects of mantle irradiation alone in selected patients with early-stage Hodgkin's disease.
  
  
  METHODS
  Between 1988 and 2000, 87 patients with pathologic stage (Ann Arbor) I-IIA or clinical stage IA Hodgkin's disease were entered on to a prospective trial of mantle irradiation alone. Patients with B symptoms, large mediastinal adenopathy, or subcarinal or hilar involvement were excluded. The median doses to the mantle field and mediastinum were 36 Gy (range 30.3-40) and 38.6 Gy (range 30.6-44), respectively. The actuarial freedom from treatment failure (FFTF) and overall survival (OS) rates were calculated using the Kaplan-Meier technique.
  
  
  RESULTS
  The median follow-up was 107 months (range 23-192). Thirteen of 87 patients (15%) relapsed at a median of 30 months (range 5-62). The 5- and 10-year actuarial FFTF rates were 86% and 84.7%, respectively. All 13 patients who relapsed are alive without evidence of disease at a median of 84 months (range 30-156) post-salvage therapy. Five patients developed a second malignancy at a median of 93 months (range 27-131). The 10-year actuarial risk of a second malignancy was 4.5%. There have been two deaths to date, both due to second malignancies. The 10-year OS rate was 98.2%.
  
  
  CONCLUSIONS
  In selected patients with early-stage Hodgkin's disease, mantle irradiation alone has an excellent long-term survival rate, comparing favorably with the previous standard treatment of extended-field radiation therapy and the current standard of combined modality therapy.
authors.affiliation: Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Ng
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.forename: D
authors.initials: D
authors.lastname: Neuberg
authors.forename: D C
authors.initials: DC
authors.lastname: Fisher
authors.forename: C
authors.initials: C
authors.lastname: McMillan
authors.forename: B
authors.initials: B
authors.lastname: Silver
authors.forename: K C
authors.initials: KC
authors.lastname: Marcus
authors.forename: M A
authors.initials: MA
authors.lastname: Stevenson
authors.forename: P M
authors.initials: PM
authors.lastname: Mauch
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006689:Hodgkin Disease / Q000517:prevention & control / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012008:Recurrence; D016879:Salvage Therapy; D013997:Time Factors; D016896:Treatment Outcome