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Grundlagen der Strahlentherapie des Morbus Hodgkin, Indikation und Ergebnisse

Principles of radiotherapy in Hodgkin's disease, indikations and results

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Summary

The radiotherapy of Hodgkin's disease is based on the knowledge of the topography of development and spread of the disease, and on the therapeutic properties and methods of application of mega volt therapy:

  1. 1.

    The clinical findings are: The disease begins in a localised area and spreads a) continually within the lymphatic system b) by local extralymphatic spread to neighbouring organs and c) by distant metastases. The spread occur according to known principles.

  2. 2.

    The theraputical findings are: The specific Hodgkin tissue is destroyed by a dose of 4000–4500 R in a high percentage.

  3. 3.

    Consequences for radiotherapy: The localised development of disease and its local progressive spread, make it possible to irradiate systematically with large continuous fields for the purpose of cure.

  4. 4.

    Results of Therapy: The 5 year survival rate of the patient in the series 1964–1969 is 66% as opposed to 42% before 1964 (Statistical significance P<0.001), the 5 year disease-free survival rate is 36% as opposed to 19% before 1964 (Statistical significance P<0.05).

Zusammenfassung

Die Strahlentherapie der Hodgkin'schen Erkrankung basiert auf den Kenntnissen über die Topographie von Entstehung und Ausbreitung der Erkrankung und der therapeutischen Wirksamkeit und den Anwendungsmöglichkeiten der Megavolttherapie.

  1. 1.

    Die krankheitsbezogenen Befunde sind: Die Erkrankung entsteht unizentrisch und breitet sich a) kontinuierlich innerhalb der Lymphsysteme, b) kontinuierlich extralymphatisch auf benachbarte Organe und c) fernmetastatisch aus. Die Ausbreitung erfolgt nach kalkulierbaren Gesetzmäßigkeiten.

  2. 2.

    Die therapiebezogenen Befunde sind: Das spezifische Hodgkingewebe wird dadurch eine Dosis von 4000–4500 rad in einem hohen Prozentsatz zerstört.

  3. 3.

    Folgerungen für die Strahlentherapie: Die unizentrische Krankheitsentstehung und vorwiegend kontinuierliche Ausbreitung ermöglichen eine systematische Bestrahlung mit großen zusammenhängenden Feldern mit kurativem Ziel.

  4. 4.

    Ergebnisse der Strahlentherapie: Die 5 Jahres-Überlebensrate des Gesamtkollektivs 1964–1969 beträgt 66% gegenüber 42% vor 1964 (Sicherung der Unterschiede P<0.001), die 5 Jahres krankheitsfreie Überlebensrate 36% gegenüber 19% vor 1964 (Sicherung der Unterschiede P<0.05).

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Literatur

  • Banfi,A., Bonadonna,G., Carnevali,G., Oldinè C., Salvine,E.: Preferential sites of involvement and spread in malignent lymphones, Europ. J. Cancer 4, 319–354 (1968).

    Google Scholar 

  • Bernard,C.W., Thomas,L.B., Axtell,L.M., Kruse,M., Newell,G., Kagan,R.: Hodgkin's disease. The relationship of histopathologic subtype to clinical stage of disense at deagnosis. Conference on staging for Hodgkin's disease. Ann Arbor, April 26–28, 1971. Cancer Res. 31, 1776–1785, 1971.

    Google Scholar 

  • Boutis,L., Hoffmann,P., Musshoff,K.: Veränderungen im peripheren Blutbild während und nach einer systematischen Bestrahlung bei der Lymphogranulonatose. Strahlentherapie 133,539, (1967).

  • Carbone,P.P., Kaplan,H.S., Musshoff,K., Smithers,I.W., Tubiana,M.: Report of the Hodgkin's disease staging classification committee. Conference on staging in Hodgkin's disease. Ann Arbor, April 26–28, 1971. Cancer Res. 31, 1860–1861 (1971).

    Google Scholar 

  • Dorfmann,R.F.: Hodgkin's disease relationship of histology to site. Conference on staging in Hodgkin's disease. Ann Arbor, April 26–28, 1971. Cancer Res. 31, 1786–1793 (1971).

    Google Scholar 

  • Frei,III E.: Definition of cure for Hodgkin's disease. Conference on staging in Hodgkin's-disease. Ann Arbor, April 26–28. Cancer Res. 31, 1848–1833 (1971).

    Google Scholar 

  • Han,T., Stutzmanu,L.: Mode of spread in patients with localized malignant lymphome. Arch iutern. Med. 120, 1 (1967).

    Google Scholar 

  • Jelliffe,A.M.: The place of radiotherapy in the cure of Hodgkin's disease. Clin. Radiol. 16, 274, 1965

    Google Scholar 

  • Facteurs influant sur la survic a long terme des Malades atteints de Maladie de Hodgkin. Supplément an J. Radiol. 24, No 1–2, 85–93 1966.

  • Johnson,R.E.: Results of radiation therapy an implications for the clinical staging of Hodgkin's disease. Conference on staging in Hodgkin's disease. Ann Arbor, April 1971. Cancer Res. 31, 1834–1837 (1971) Irradation of the spleen in the management of Hodgkin's disease, (in press)

    Google Scholar 

  • Kagan,A.R., Hafermann,M.D. and Keyes,I.W.: Patient tolerance to extended irradiation in Hodgkin's disease. Ann intern. Med. 70, 1 (1969).

    Google Scholar 

  • Kaplan,H.S.: Radical radiotherapy of regionally localized Hodgkin's disease. Radiology 78, 553–561 (1962).

    Google Scholar 

  • — Role of intensive radiotherapy in the management of Hodgkin's disease. Cancer 19, 356–367 (1966).

    Google Scholar 

  • — Evidence for a tumoridical dose level in the radiotherapie of Hodgkin's disease. Cancer Res. 26, 1221–24 (1966).

    Google Scholar 

  • — Prognostic significance of relapse-free interval after radiotherapy in Hodgkin's disease. Cancer 22, 1131–1136 (1968).

    Google Scholar 

  • — Role of intensive radiotherapy in the management of Hodgkin's disease. Cancer 19, 356–367 (1966).

    Google Scholar 

  • — On the natural history, treatment and prognosis of Hodgkin's disease. The Harney Lectures Series 64 page 215–259. New York-London: Academic Press 1970.

    Google Scholar 

  • Rosenberg,A.S.: La radiotherapie segmentaire de la maladie de Hodgkin. Premiers résultats de deux essais thérapeutiques controlés. Nouv. Rev. franç, Hemat. 6, 121–133 (1966a).

    Google Scholar 

  • — Extended-Field radical radiotherapy in advanced Hodgkin's disease: Short-Term results of 2 randomized clinical trials. Cancer Res. 26, 1268–1276, (1966b).

    Google Scholar 

  • Laeger,K.K.R.: Entstehung und Ausbreitung der Hodgkinschen Erkrankung nach Strahlen-therapie. Inauguraldissertation Freiburg i. Br. 1971.

  • Landberg,T, Larson L.-E.: Hodgkin's disease. Retrospective clinice pathologic study in 149 patients. Acta Radiol. Ther. Phys. 8, 390 (1969).

    Google Scholar 

  • Lukes,R.J.: Relationship of histologic features to clinical stages in Hodgkin's disease. Amer. J. Roentgenol. 90, 944–955 (1963).

    Google Scholar 

  • —Butler,J.J.: The pathology and nomenclature of Hodgkin's disease. Cancer R. 26,1063–1081, (1966).

    Google Scholar 

  • Musshoff,K.: Therapy and prognosis of two different forms of organ involement in cases of malignant lymphoma (Hodgkin's disease, Reticulumcellsarcoma, Lymphosarcoma) as well as a report about stage civision in these disease. XII. International Congress of Radiology. Tokyo Oct. 6–11, 1969, Abstracts page 77. Klin. Wschr. 48, 673–678 (1970).

    Google Scholar 

  • — Prognostic and therapeutic implicatioons of staging in extranodal Hodgkin's disease. Conference on staging in Hodgkin's disease. Ann Arbor, April 26–28, 1971. Cancer Res. 31, 1814–1827 (1971).

    Google Scholar 

  • — Boutis,L.: Die Frage der Heilbarkeit der Lymphogranulomatose beurteilt nach den Behandlungsergebnissen der Freiburger Medizinischen Klinik. 73. Tagung der deutschen Gesellschaft innere Medizin von 3.–6. April 1967. Verh. dtsch. Ges. inn. Med. 73, 322–329 (1967).

    Google Scholar 

  • — Kalkoff,P., Strickstock,K.H., Böhmert,A., Mayer,W., MertenD.: Zur Strahlenbehandlung der Hodgkinschen Erkrankung. Strahlentherapie, 141, 381–389, (1971).

    Google Scholar 

  • —Oehlert,W., Hahmann,W., Nuss,A.: Klinik, Pathologie und Therapie von Patienten mit geheilten Morbus Hodgkin. Klin. Wschr. 47, 1175–1176 (1969).

    Google Scholar 

  • — Radiation Therapy and Cure in Hodgkin's disease. Acta Radiol. 9, 289–301 (1970).

    Google Scholar 

  • —, Renemann,H., Boutis,L., Afkham,J.: Die extranoduläreLymphogranulomatose Diagnose, Therapie und Prognose bei zwei unterschiedlichen Formen des Organbefalls. Ein Beitrag zur Satdieneinteilung des Morbus Hodgkin. Fortschr. Röntgenstr. 109, 776–786 (1968).

    Google Scholar 

  • —: The differentiation of two different types of stage IV of Hodgkin's disease. II. International Congress of Lymphology. Miami, March 15.–20., 1968. Abstracts No 171. Progress in Lymphology II. S. 272–275. Stuttgart, Thieme, 1970.

    Google Scholar 

  • - Stamm,H., Lummer,G., Gössel,K.: Zur Prognose der Lymphogranulomatose Klinisches Bild und Strahlentherapie. In: Beiträge der inn. Medizin. S. 549–561. Hrsg. Kleidering-Schattauer Verlag, 1964.

  • Peters,M.V.: A. study of survivales in Hodgkin's disaese treated radiologically. Amer. J. Roentgenol. 63, 299–311 (1950). A clinical classification of the malignant lymphomas related to the course of the disease. II International Congress of lymphology Miami March 15–20,1968.

    Google Scholar 

  • - Hasselback,R., Brown,T.C.: The natural history of the lymphomes related to the clinical classifications, Proc. of the International Conference on Leukamia-Lymphoma, C.F. Zavafonatis (Ed), p. 357–370, 1968.

  • - Middlemisas,K.C.H.: A study of Hodgkin's disease treated by irradiation.

  • Rappaport,H., Strum,St. B.: Vascular invasion in Hodgkin's disease. Its incidence and relationship to the spread of the disease. Cancer 25, 1304–1313 (1970).

    Google Scholar 

  • Rosenberg,S.A.: Report of the Staging Committee of Hodgkin's disease. Cancer Res. 26, 1310 (1966)

    Google Scholar 

  • —, Kaplan,H.S.: Evidence for an orderly progression in the spread of Hodgkin's disease. Cancer Res. 26, 1225–1230 (1966).

    Google Scholar 

  • — Kaplan,H.S. Hodgkin's disease and other malignant lymphomes. Calif. Med. 113, 23–38 (1970)

    Google Scholar 

  • Salzman, J.R., Kaplan, H.S.: Effert of splenectomy on hematological tolerance during total lymphoid radiotherapy of patients with Hodgkin's disease. Cancer (in press).

  • Strickstrock,K.H., Musshoff,K., Boutis,L.: Methode der zusätzlichen prophylaktischen Bestrahlung bei der Lymphogranulomatose. Strahlentherapie 133, 337 (1961).

    Google Scholar 

  • Tubiana,M., Rambert,P., Laugier,A., Lalanne C.M.: Les irradiations étendues dans la maladie de Hodgkin. Réaction précoses. Nouv. Rev. franç. Hemat. 6: 164–173, (1966b).

    Google Scholar 

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Authors and Affiliations

  1. Strahlenabteilung Medizenische-Universitätsklinik, Hugstetterstr. 55, D-7800, Freiburg, Bundesrepublik Deutschland

    Karl Musshoff

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Referat gehalten auf der 11. wissenschaftlichen Tagung der Deutschen Krebsgesellschaft Hannover 1971.

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Musshoff, K. Grundlagen der Strahlentherapie des Morbus Hodgkin, Indikation und Ergebnisse. Z. Krebsforsch. 78, 162–191 (1972). https://doi.org/10.1007/BF00285261

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