The significance of the residual mediastinal mass in treated Hodgkin's disease.

The chest roentgenograms of 65 patients treated for Hodgkin's disease with mediastinal adenopathy were analyzed retrospectively to determine the incidence and significance of residual mediastinal abnormality after treatment. All patients were treated with radiation therapy, and 36 patients received additional chemotherapy. On completion of treatment, 57 (88%) of the 65 patients had some residual mediastinal abnormality. These were either minimal changes in the mediastinal shadow in 30 patients or a widening greater than 6 cm in 27 patients. In the latter group, 11 (40%) of 27 patients continued to have residual mediastinal widening one year after completion of therapy. These patients did not have a higher incidence of recurrence. Long-term follow-up (median, 48 months) revealed continued abnormalities in 24 (40%) of the original 57 patients. Mediastinal abnormalities are common at the end of radiation or combined modality therapy for Hodgkin's disease and do not by themselves indicate persistent active disease or an increased risk for relapse. We strongly recommend that additional chemotherapy or higher radiation doses beyond the initially planned course not be used for residual mediastinal widening.

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Low mortality from lymphocyte predominant hodgkin's disease with long-term follow-up

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(94)90824-9 ◽

1994 ◽

Vol 30 ◽

pp. 268-269

Author(s):

Stephan Bodis ◽

Madeleine Kraus ◽

Geraldine Pinkus ◽

Barbara Silver ◽

Peter Mauch

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Long Term Follow Up

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Long-Term Follow-up of Residual Mediastinal Masses in Treated Hodgkin's Disease Using MR Imaging

Acta Radiologica ◽

10.1177/02841851960371p168 ◽

1996 ◽

Vol 37 (1P1) ◽

pp. 323-326 ◽

Cited By ~ 5

Author(s):

R. Nyman ◽

G. Forsgren ◽

B. Glimelius

Keyword(s):

Mr Imaging ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Mediastinal Masses ◽

Long Term Follow Up ◽

Residual Masses ◽

The Masses ◽

Post Therapy

Purpose: Long-term follow-up of residual mediastinal masses in treated Hodgkin's disease using MR imaging. Material and Methods: Ten patients, with substantial residual mediastinal masses of low signal intensity (SI) in the T2-weighted image (T2WI), were reinvestigated with MR 19–79 months after completing treatment of Hodgkin's disease. All patients were in complete remission. Results: During the follow-up period, the masses had decreased in size by 0–95% (median 67%) as compared to their initial post-therapy size. The SI continued to be low in the T2WI and was unaffected by the degree of size reduction. Conclusion: It is speculated that these mainly fibrotic residual masses undergo slow degradation of the fibrotic part and/or resorption of remaining inflammatory tissue. It is important to understand the natural, long-term MR imaging changes of these residual masses in order more easily to recognize tumour recurrence or other pathologic conditions.

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Unusual thoracic radiographic findings in children treated for Hodgkin's disease.

Journal of Clinical Oncology ◽

10.1200/jco.1986.4.6.874 ◽

1986 ◽

Vol 4 (6) ◽

pp. 874-882 ◽

Cited By ~ 10

Author(s):

M S Jochelson ◽

N J Tarbell ◽

H J Weinstein

Keyword(s):

Hodgkin's Disease ◽

Radiation Pneumonitis ◽

Hodgkin’S Disease ◽

Combined Modality Therapy ◽

Radiographic Findings ◽

Appropriate Treatment ◽

Mediastinal Widening ◽

Lung Periphery ◽

Inflammatory Changes ◽

Radiographic Changes

Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.

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Secondary Leukemia following Treatment for Hodgkin's Disease

Tumori Journal ◽

10.1177/030089169307900204 ◽

1993 ◽

Vol 79 (2) ◽

pp. 103-107 ◽

Cited By ~ 9

Author(s):

Luigi Salvagno ◽

Lorenzo Simonato ◽

Mariella Sorarù ◽

Antonio Bianco ◽

Vanna Chiarion-Sileni ◽

...

Keyword(s):

Hodgkin's Disease ◽

Odds Ratio ◽

Case Control Study ◽

Hodgkin’S Disease ◽

Treatment Modalities ◽

Secondary Leukemia ◽

Increased Risk ◽

Radiotherapy Alone ◽

One Year ◽

Control Study

Aims and Background Patients treated for Hodgkin's disease with chemotherapy or with the association of chemotherapy and radiotherapy have an increased risk of secondary leukemia. The aim of this study was to evaluate the leukemogenic risk due to these treatment modalities. Methods We performed a case-control study on a population of 1410 patients treated for Hodgkin's disease from 1970 to 1990 in our Institute. Among these patients, we identified 25 cases of secondary leukemia and 3 cases of myelodysplasia, all occurring more than one year after the diagnosis of Hodgkin's disease. Three cases occurred among the patients treated with radiotherapy alone. When we analyzed the risk in relation to the type of treatment (radiotherapy, chemotherapy, or both), the comparisons were relative to patients treated with radiotherapy alone. Results We found that chemotherapy alone is associated with a fivefold increased risk (odds ratio = 5.4) compared with radiotherapy alone. When both treatments are used, the risk is not further increased (odds ratio = 4.4). Patients receiving more than 6 courses of chemotherapy have an excess risk (relative risk = 2.5) compared with those treated with 6 courses or less. No increased risk was observed after splenectomy. Conclusions This study confirms an increased incidence of secondary leukemia occurring in patients treated for Hodgkin's disease. The increased risk seems to be correlated with the number of courses of alkylating agent therapy, whereas it is unaffected by the addition of radiotherapy.

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Long-term follow-up with ABDIC salvage chemotherapy of MOPP-resistant Hodgkin's disease.

Journal of Clinical Oncology ◽

10.1200/jco.1983.1.7.432 ◽

1983 ◽

Vol 1 (7) ◽

pp. 432-439 ◽

Cited By ~ 36

Author(s):

N Tannir ◽

F Hagemeister ◽

W Velasquez ◽

F Cabanillas

Keyword(s):

Complete Remission ◽

Median Survival ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Survival Curve ◽

Salvage Chemotherapy ◽

Significant Prognostic Factor ◽

Long Term Follow Up

Thirty-six consecutive patients with advanced recurrent Hodgkin's disease resistant to chemotherapy with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) were treated with doxorubicin (Adriamycin), bleomycin, (dacarbazine) DTIC, (lomustine) CCNU, and prednisone (ABDIC). Among the 34 patients evaluable for response, complete remission occurred in 35% and partial remission in 35%. The achievement of complete remission during primary MOPP induction was a statistically significant prognostic factor that predicted complete remission with ABDIC (p less than 0.01). The median time to complete remission was 2 months (range 1-11 mo). The median relapse-free survival time for complete responders is 47 months, and an estimated 53% of all patients who achieve complete remission are projected to be alive, free of disease off therapy at 3 years from initiation of ABDIC. The median survival of all patients is 24 months. The median survival of complete responders, partial responders, and nonresponders is 70, 17, and 4 months, respectively. The survival curve for complete responders is significantly different from that for partial responders (p less than 0.01); the survival curve for partial responders is also significantly different from that of nonresponders (p less than 0.01). Toxicity of ABDIC was acceptable; only one patient died from complications of myelosuppression. Our results indicate that ABDIC is a potentially curative regimen for a fraction of patients with MOPP-resistant Hodgkin's disease who achieve complete remission with prior MOPP therapy. It also prolongs the survival of patients who do not achieve complete remission with prior MOPP therapy.

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