Irradiation of stage I and II Hodgkin's disease

This retrospective analysis was undertaken to document the results of varying doses and treatment volumes on the survival, complication, local recurrence and extension rates of 147 patients with Stage I and II Hodgkin's disease. The role of the primary site and histologic subtype was examined. One must conclude on the basis of this study that tumor doses in excess of 3,600 or 4,000 rad add only to morbidity, and not to local control. Secondly, the technique of irradiating involved lymph node groups only, leaving other areas to be treated 'later', apparently denies the possibility of cure to a significant number of patients with early stage Hodgkin's disease. Recurrence or extension almost uniformly leads to eventual death from disease despite retreatment. No case of second primary cancer has been documented in the patient population included in this report. However, the number at risk is relatively small and chemotherapy was reserved only for generalized recurrence. Since the reported 20 times expected incidence occurred with the combination of total nodal and multiple agent chemotherapy, one would not expect an increased incidence of second primary lesions in this series.