78 Long term results of mantle irradiation(MRT) alone in 261 patients with clinical stage I–II supradiaphragmatic Hodgkin's disease

Author(s):  
A Wirth ◽  
D Byram ◽  
M Chao ◽  
J Corry ◽  
S Davis ◽  
...  
1996 ◽  
Vol 7 (2) ◽  
pp. 145-150 ◽  
Author(s):  
A. Foss Abrahamsen ◽  
E. Hannisdal ◽  
O. Nome ◽  
H. Holte ◽  
B. Hager ◽  
...  

1967 ◽  
Vol 53 (2) ◽  
pp. 111-128 ◽  
Author(s):  
Sergio Di Pietro

Long-term results of 100 cases of Hodgkin's disease, treated with chemotherapy associated or not with X-ray therapy from 1949 to 1900, are reported. The median, survival rate was of 36 months: at 5 years the rate was 25 %. The survival rate at 5 years was 34,2 % for the 38 women and 19.3 % for the 62 men treated. Of 66 cases of the third clinical stage 31.6 % was alive at 5 years; the corresponding value for the 40 cases of the fourth stage was 15 %. The best survival rate was observed in the group of women of the third clinical stage with involvement of ilo-mediastinic lymph nodes in the first period of the disease (52.6% at 5 years). As to the four histological varieties of our cases, one can observe that the «paragranuloma» and the «scleronodular» types show a fairly good survival rate, not depending on the clinical stage, whereas the «polymorphous» and «sarcomatous» ones cause a more severe prognosis for the patients of the fourth clinical stage. The age of the patients, evidence or not of « systemic » symptoms, and the duration of the disease before the first treatment don't seem to have any significant influence on the survival rate. The best results were obtained with chemotherapy-X-ray therapy association in the group of patients of the third stage (survival rate of 39.5 % at 5 years). No difference is noted, on the contrary, between long-term results of chemotherapy alone and those of chemotherapy associated with X-therapy in the fourth stage.


2009 ◽  
Vol 63 (2) ◽  
pp. 126-133 ◽  
Author(s):  
Riccardo Maurizi Enrici ◽  
Mattia Falchetto Osti ◽  
Alfredo Zurlo ◽  
Anna Paola Anselmo ◽  
Valter Iacari ◽  
...  

2005 ◽  
Vol 173 (4S) ◽  
pp. 116-117
Author(s):  
Hannes Steiner ◽  
Reinhard Peschel ◽  
Tilko Müller ◽  
Christian Gozzi ◽  
Georg C. Bartsch ◽  
...  

2001 ◽  
Vol 19 (3) ◽  
pp. 736-741 ◽  
Author(s):  
Kendall H. Backstrand ◽  
Andrea K. Ng ◽  
Ronald W. Takvorian ◽  
Ellen L. Jones ◽  
David C. Fisher ◽  
...  

PURPOSE: To determine the efficacy of mantle radiation therapy alone in selected patients with early-stage Hodgkin’s disease. PATIENTS AND METHODS: Between October 1988 and June 2000, 87 selected patients with pathologic stage (PS) IA to IIA or clinical stage (CS) IA Hodgkin’s disease were entered onto a single-arm prospective trial of treatment with mantle irradiation alone. Eighty-three of 87 patients had ≥ 1 year of follow-up after completion of mantle irradiation and were included for analysis in this study. Thirty-seven patients had PS IA, 40 had PS IIA, and six had CS IA disease. Histologic distribution was as follows: nodular sclerosis (n = 64), lymphocyte predominant (n = 15), mixed cellularity (n = 3), and unclassified (n = 1). Median follow-up time was 61 months. RESULTS: The 5-year actuarial rates of freedom from treatment failure (FFTF) and overall survival were 86% and 100%, respectively. Eleven of 83 patients relapsed at a median time of 27 months. Nine of the 11 relapses contained at least a component below the diaphragm. All 11 patients who developed recurrent disease were alive without evidence of Hodgkin’s disease at the time of last follow-up. The 5-year FFTF in the 43 stage I patients was 92% compared with 78% in the 40 stage II patients (P = .04). Significant differences in FFTF were not seen by histology (P = .26) or by European Organization for Research and Treatment of Cancer H-5F eligibility (P = .25). CONCLUSION: Mantle irradiation alone in selected patients with early-stage Hodgkin’s disease is associated with disease control rates comparable to those seen with extended field irradiation. The FFTF is especially favorable among stage I patients.


1997 ◽  
Vol 15 (2) ◽  
pp. 528-534 ◽  
Author(s):  
V Bonfante ◽  
A Santoro ◽  
S Viviani ◽  
L Devizzi ◽  
M Balzarotti ◽  
...  

PURPOSE This study analyzed long-term results in patients with Hodgkin's disease who were resistant to or relapsed after first-line treatment with MOPP and ABVD. Response to salvage treatments and prognostic factors were also evaluated. PATIENTS AND METHODS The study population included 115 refractory or relapsed patients among a total of 415 patients treated with alternating or hybrid MOPP-ABVD followed by radiotherapy (25 to 30 Gy) to initial bulky sites. The median follow-up duration of the present series was 91 months. Thirty-nine of 115 patients (34%) showed disease progression while on primary treatment (induction failures); 48 relapsed after complete remissions that lasted < or = 12 months and 28 after complete remission that lasted more than 12 months from the end of all treatments. RESULTS At 8 years, the overall survival rate was 27%, being 54% and 28% in patients whose initial complete remission was longer or shorter than 12 months, respectively, and 8% in induction failures (P < .001). Response to first-line chemotherapy and disease extent at first progression significantly influenced long-term results, as well as the incidence and duration of complete remission. CONCLUSION The present data confirm previous observations that showed the main prognostic factors to influence outcome after salvage treatment are response duration to first-line therapy and disease extent at relapse. The results indicate that patients who relapse after the alternating MOPP/ABVD regimen have a prognosis similar to that of patients who relapse after a four-drug regimen (MOPP or ABVD alone). Re-treatment with initial chemotherapy seems the treatment of choice for patients who relapse after an initial complete remission that lasts greater than 12 months, while the real impact of high-dose chemotherapy or new regimens should be assessed in resistant patients.


1990 ◽  
Vol 8 (7) ◽  
pp. 1128-1137 ◽  
Author(s):  
S S Donaldson ◽  
S J Whitaker ◽  
P N Plowman ◽  
M P Link ◽  
J S Malpas

The results of treatment of 171 children with stage I-II Hodgkin's disease from two institutions with differing approaches to management have been analyzed. At the Stanford University Medical Center/Children's Hospital at Stanford (SUMC/CHaS), pathologic staging followed by extended-field radiation alone or involved-field radiation plus combination chemotherapy have been cardinal to the management policy. At St Bartholomew's Hospital/The Hospital for Sick Children at Great Ormond Street (Barts/GOS), clinical staging only has been used over the last 10 years, and involved/regional-field radiotherapy used as the treatment of choice rather than extended-field radiotherapy. Some children at each institution received combined modality therapy as primary management. Relapse among children with stage I disease was a more frequent occurrence in the Barts/GOS series than in the SUMC/CHaS group. However, the survival rates from the two centers are identical, 91% at 10 years. The following scientific-philosophic question is asked: Should one maximally stage and treat all children to increase the likelihood of a high freedom from relapse (FFR; cure) rate, or is it acceptable to minimize the initial staging and treatment, realizing that a proportion of patients will fail and require salvage/rescue therapy? With the awareness of morbidity from pathologic staging and aggressive treatment, and the favorable survival data reported from specialized centers using differing approaches, treatment strategies should be directed toward the long-term goal of cure of disease with maximal quality of life. A multidisciplinary management philosophy undertaken at a center with extensive experience in pediatric Hodgkin's disease is important to achieving this goal.


2001 ◽  
Vol 19 (11) ◽  
pp. 2905-2914 ◽  
Author(s):  
Eckhart Dühmke ◽  
Jeremy Franklin ◽  
Michael Pfreundschuh ◽  
Susanne Sehlen ◽  
Norman Willich ◽  
...  

PURPOSE: To show that radiotherapy (RT) dose to the noninvolved extended field (EF) can be reduced without loss of efficacy in patients with early-stage Hodgkin’s disease (HD). PATIENTS AND METHODS: During 1988 to 1994, pathologically staged patients with stage I or II disease who were without risk factors (large mediastinal mass, extranodal lesions, massive splenic disease, elevated erythrocyte sedimentation rate, or three or more involved areas) were recruited from various centers. All patients received 40 Gy total fractionated dose to the involved field areas but were randomly assigned to receive either 40 Gy (arm A) or 30 Gy (arm B) total fractionated dose for the clinically noninvolved EF. No chemotherapy was given. RT films were prospectively reviewed for protocol violations and recurrences retrospectively related to the applied RT. RESULTS: Of 382 recruited patients, 376 were eligible for randomized comparison, 190 in arm A and 186 in arm B. Complete remission was attained in 98% of patients in each arm. With a median follow-up of 86 months, 7-year relapse-free survival (RFS) rates were 78% (arm A) and 83% (arm B) (P = .093). The upper 95% confidence limit for the possible inferiority of arm B in RFS was 4%. Corresponding overall survival rates were 91% (arm A) and 96% (arm B) (P = .16). The most common causes of death (n = 27) were cardiorespiratory disease/pulmonary embolisms (seven), second malignancy (six), and HD (five). Protocol violation was associated with significantly poorer RFS. Nonirradiated nodes were involved in 42 of 52 reviewed relapses, infield areas in 18, marginal areas in 17, and extranodal sites in 16. CONCLUSION: EF-RT alone attains good survival rates in favorable early-stage HD. The 30-Gy dose is adequate for clinically noninvolved areas. Protocol violation worsens the subsequent prognosis. Relapse patterns suggest that systemic therapy can reduce the 20% long-term relapse rate.


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