Abstract
Improvements in results of treatment for Hodgkin's disease have been dramatic in the last 20 years. The results of high dose radiation therapy are reviewed in terms of the importance of the extent of the field of irradiation. The importance of adjuvant chemotherapy is also discussed. Problem areas both in staging and in general management of patients with Hodgkin's disease are emphasized. Long-term complications of treatment, both radiotherapeutic and chemotherapeutic,are stressed. The excellent results of management for stage I, I1 (A and B), and IIIA Hodgkin's disease have reached a level at which future studies must aim at reducing the morbidity of treatment. I with Hodgkin's disease have generally paralleled the improvements in the techniques of radiation therapy. From the era of Gilbert,' through the first reports of Peters," to the successful results reported today by various medical centers, 5, 10, 12, 18, 22, 24 we have reached a degree of optimism in dealing with Hodgkin's disease that would have shocked our colleagues of only 15 years ago. The basis for this optimism represents the blending of several factors in addition to complex megavoltage radiotherapeutic techniques; vastly improved diagnostic techniques (i.e., lymphangiography), careful surgical staging, and the recent development of effective combination chemotherapy in the form of MOPP' are all contributing factors. The interplay of these elements has made Hodgkin's disease unique among malignant diseases for the systematic approach to its staging and treatment;" in fact, the methodical study of Hodgkin's disease over the past two decades serves as a valuable model for the investigation of other malignant diseases. The purpose of this communication is to review the accomplishments of radiotherapy in the management of patients with Hodgkin's disease in light of the modern, multimodality approach to treatment. In addition, certain problem areas in the management of these patients will be emphasized.
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