TY - JOUR
T1 - The management of stage I-II Hodgkin's disease with irradiation alone or combined modality therapy
T2 - The Stanford experience
AU - Hoppe, R. T.
AU - Coleman, C. N.
AU - Cox, R. S.
AU - Rosenberg, S. A.
AU - Kaplan, H. S.
PY - 1982
Y1 - 1982
N2 - At Stanford University, between 1968 and 1978, 230 patients with pathologic stage I-II Hodgkin's disease were treated on prospective clinical trials with either irradiation alone or irradiation followed by 6 cycles of adjuvant combination chemotherapy. The actuarial survival at 10 yr was 84% for patients in either treatment group. Freedom from relapse at 10 yr was 77% among patients treated with irradiation alone and 94% after treatment with combined modality therapy [p(Gehan) = 0.09]. Freedom from second relapse at 10 yr was 89% and 94%, respectively [p(Gehan) = 0.56]. Several prognostic factors were evaluated in order to identify patients at high risk for relapse or with poor ultimate survival after initial treatment with irradiation alone. Systemic symptoms, histologic subtype, age, and limited extranodal involvement (E-lesions) did not affect the prognosis of patients and failed to identify patients whose survival could be improved by the routine use of combined modality therapy. Patients with large mediastinal masses (mediastinal mass ratio ≥ 1/3) had a significantly poorer freedom from relapse when treated with irradiation alone than when treated initially with combined modality therapy [45% versus 81% at 10 yr, p(Gehan) = 0.03). The 10-yr survival of these patients, however, was not significantly different (84% versus 74%). The implications of these observations on the management of patients with early stage Hodgkin's disease are discussed.
AB - At Stanford University, between 1968 and 1978, 230 patients with pathologic stage I-II Hodgkin's disease were treated on prospective clinical trials with either irradiation alone or irradiation followed by 6 cycles of adjuvant combination chemotherapy. The actuarial survival at 10 yr was 84% for patients in either treatment group. Freedom from relapse at 10 yr was 77% among patients treated with irradiation alone and 94% after treatment with combined modality therapy [p(Gehan) = 0.09]. Freedom from second relapse at 10 yr was 89% and 94%, respectively [p(Gehan) = 0.56]. Several prognostic factors were evaluated in order to identify patients at high risk for relapse or with poor ultimate survival after initial treatment with irradiation alone. Systemic symptoms, histologic subtype, age, and limited extranodal involvement (E-lesions) did not affect the prognosis of patients and failed to identify patients whose survival could be improved by the routine use of combined modality therapy. Patients with large mediastinal masses (mediastinal mass ratio ≥ 1/3) had a significantly poorer freedom from relapse when treated with irradiation alone than when treated initially with combined modality therapy [45% versus 81% at 10 yr, p(Gehan) = 0.03). The 10-yr survival of these patients, however, was not significantly different (84% versus 74%). The implications of these observations on the management of patients with early stage Hodgkin's disease are discussed.
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U2 - 10.1182/blood.v59.3.455.455
DO - 10.1182/blood.v59.3.455.455
M3 - Article
C2 - 7059665
AN - SCOPUS:0020081112
VL - 59
SP - 455
EP - 465
JO - Advances in Water Resources
JF - Advances in Water Resources
SN - 0309-1708
IS - 3
ER -