Indications for combined modality therapy in patients with Hodgkin’s disease

  • A. Zabell
  • E. Glatstein
Part of the Developments in Oncology book series (DION, volume 32)

Abstract

In the last 4 decades, the study of Hodgkin’s disease has gone through a remarkable revolution. It began with an assumption of incurability. Treatment was usually palliative in intent, although the disease was known to be responsive to radiation. The classic studies of Peters, Kaplan, and others elucidated the natural history of the disease, in particular its orderly spread, propensity to remain in nodes and the spleen, and its likelihood for microscopic involvement in clinically and radiographically negative nodal groups. It was, however, the development of megavoltage x-ray equipment that allowed the delivery of wide field high-dose radiation with acceptable toxicity and curative intent. Subsequently, the development of effective combination chemotherapy made cure possible for patients whose advanced disease was not amenable to treatment by radiation. Today, cure rates for ‘early stage’ disease treated by radiation are over 80% as reported by many groups [l–3], and cure in advanced stage disease with combination chemotherapy is about 50% [4].

Keywords

Toxicity Lymphoma Leukemia Shrinkage Oncol 

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References

  1. 1.
    Rosenberg SA, Kaplan HS, Glatstein E and Portlock CS (1978). Combined modality therapy of Hodgkin’s disease. Cancer 42: 991–1000.PubMedCrossRefGoogle Scholar
  2. 2.
    Glatstein E (1977). Radiotherapy for Hodgkin’s disease. Past achievements and future progress. Cancer 39: 837–843.PubMedCrossRefGoogle Scholar
  3. 3.
    Goodman RL, Piro AJ and Hellman S (1976). Can pelvic irradiation be omitted in patients with pathologic Stage IA and IIA Hodgkin’s disease? Cancer 37: 2834–2839.PubMedCrossRefGoogle Scholar
  4. 4.
    DeVita VT, Simon RM, Hubbard SM et al. (1980). Curability of advanced Hodgkin’s disease with chemotherapy: Long term follow-up of MOPP treated patients at NCI. Ann Intern Med 92: 587–595.PubMedGoogle Scholar
  5. 5.
    Hoppe RT, Coleman CN, Cox RS et al. (1982). The management of Stage I-II Hodgkin’s disease with irradiation alone or combined modality therapy: The Stanford experience. Blood 59: 455–465.PubMedGoogle Scholar
  6. 6.
    Mauch P, Goodman R and Hellman S (1978). The significance of mediastinal involvement in early stage Hodgkin’s disease. Cancer 42: 1039–1045.PubMedCrossRefGoogle Scholar
  7. 7.
    Velentjas E, Barett A, McElwain J et al. (1978). Mediastinal involvement in early stage Hodgkin’s disease. Eur J Cancer 42: 1039–1045.Google Scholar
  8. 8.
    Thar TL, Million RR, Hausner RT et al. (1979). Hodgkin’s disease Stage I and II: Relationship of recurrence to size of disease, radiation dose, and number of sites involved. Cancer 43: 1101–1105.PubMedCrossRefGoogle Scholar
  9. 9.
    DeVita VT, Young RC and Chabner BA. Unpublished data.Google Scholar
  10. 10.
    Carmel RJ, Kaplan HS (1976). Mantle irradiation in Hodgkin’s disease. An analysis of technique, tumor irradiation and complications. Cancer 37: 2812–2825.CrossRefGoogle Scholar
  11. 11.
    Piro AJ, Weiss DR and Hellman S (1976). Mediastinal Hodgkin’s disease: A possible danger for intubation anesthesia. Int J Radiat Oncol Biol Phys 1: 415–419.PubMedCrossRefGoogle Scholar
  12. 12.
    Levi JA and Wiernik PH (1977). Limited extra nodal Hodgkin’s disease: Unfavorable prognosis and therapeutic implications. Amer J Med 63: 365–372.PubMedCrossRefGoogle Scholar
  13. 13.
    Torti FM, Portlock CS, Rosenberg SA and Kaplan HS (1981). Extra-lymphatic Hodgkin’s disease: Prognosis and response to therapy. Amer J Med 70: 487–492.PubMedCrossRefGoogle Scholar
  14. 14.
    Desser RK, Golomb HM, Ultman JE et al. (1977). Prognostic classification of Hodgkin’s disease in pathologic Stage III based on anatomic considerations. Blood 49: 883–893.PubMedGoogle Scholar
  15. 15.
    Stein RS, Golomb HM, Diggs CH et al. (1980). Anatomic substages of Stage IIIA Hodgkin’s disease. Ann Intern Med 92: 159–165.PubMedGoogle Scholar
  16. 16.
    Hoppe RT, Rosenberg SA and Kaplan HS (1980). Prognostic factors in pathologic Stage IIIA Hodgkin’s disease. Cancer 46: 1240–1246.PubMedCrossRefGoogle Scholar
  17. 17.
    Krikorian JG, Portlock CS, Rosenberg SA and Kaplan HS (1979). Hodgkin’s disease occurring below the diaphragm. Cancer 43: 1866–1871.PubMedCrossRefGoogle Scholar
  18. 18.
    Farber LR, Prosnitz LR and Cadman EC (1980). Curative potential of combined modality therapy for advanced Hodgkin’s disease. Cancer 46: 1509–1517.PubMedCrossRefGoogle Scholar
  19. 19.
    Goodman R, Mauch P, Piro A et al. (1977). Stage IIB and IIIB Hodgkin’s disease: Results of combined modality treatment. Cancer 40: 84–89.PubMedCrossRefGoogle Scholar
  20. 20.
    Kun LE, DeVita VT, Young RC et al. (1976). Treatment of Hodgkin’s disease using intensive chemotherapy followed by irradiation. Int J Radiat Oncol Biol Phys 1: 619–626.PubMedCrossRefGoogle Scholar
  21. 21.
    Hoppe RT, Portlock CS, Glatstein E et al. (1979). Alternating chemotherapy and irradiation in the treatment of advanced Hodgkin’s disease. Cancer 43: 472–481.PubMedCrossRefGoogle Scholar
  22. 22.
    Mauch P, Rosenthal D, Canellos G et al. Reduction of fatal complications from combined modality therapy in Hodgkin’s disease. (Submitted for publication).Google Scholar
  23. 23.
    Fraass BA, Kinsella TJ, Harrington FS and Glatstein E. Peripheral dose to the testes: The design and clinical use of a practical and effective gonadal shield. Int J Radiat Oncol Biol Phys (in press).Google Scholar
  24. 24.
    Coleman CN, Kaplan HS, Cox R et al. Leukemias, non-Hodgkin’s lymphomas and solid tumors in patients treated for Hodgkin’s disease. Cancer Surveys (in press).Google Scholar
  25. 25.
    Coltman CA, Dixon DO (1982). Second malignancies complicating Hodgkin’s disease: A Southwest Oncology Group 10 year follow-up. Cancer Treat Rep 66: 1023–1033.PubMedGoogle Scholar
  26. 26.
    Glicksman AS, Pajak TF, Gottlieb A et al. (1982). Second malignant neoplasms in patients successfully treated for Hodgkin’s disease: A Cancer and Leukemia Group B study. Cancer Treat Rep 66: 1035–1044.PubMedGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers, Boston 1985

Authors and Affiliations

  • A. Zabell
    • 1
  • E. Glatstein
    • 1
  1. 1.Radiation Oncology Branch, Division of Cancer TreatmentNational Cancer InstituteBethesdaUSA

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