Extended field radiation therapy in Hodgkin's disease. Analysis of failures

A retrospective analysis of 116 primary cases of stage I, II and III‐A Hodgkin's disease demonstrated 27 failures, fourteen confirmed by biopsy. Twenty of the 27 (74%) were in lymph node areas only and seven had extranodal extensions. The most frequent site of failure was the hilar nodes and co...

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Bibliographic Details
Published in:Cancer 1977-12, Vol.40 (6), p.2896-2904
Main Authors: Mill, William B., Palmer‐Hanes, Lily A., Purdy, James A., Tillack, Thomas W., Reinhard, Edward H., Loeb, Virgil, Parnell, Denyse N., Penkoske, Michaele A., Franssila, Kaarle O.
Format: Article
Language:English
Subjects:
Female
Hodgkin Disease - pathology
Hodgkin Disease - radiotherapy
Humans
Lymph Nodes - pathology
Male
Prognosis
Radiotherapy Dosage
Recurrence
Retrospective Studies
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Summary:A retrospective analysis of 116 primary cases of stage I, II and III‐A Hodgkin's disease demonstrated 27 failures, fourteen confirmed by biopsy. Twenty of the 27 (74%) were in lymph node areas only and seven had extranodal extensions. The most frequent site of failure was the hilar nodes and contiguous lung. The majority of failures (78%) occurred within 30 months of treatment and the cause of failure determined in 23 (85%), sixteen of which were due to technical errors of irradiation. Analysis of the dosimetry in the mediastinal, hilar nodes and contiguous lung failures revealed three factors which may have contributed to a low dose. These factors are: 1) the equivalent square, 2) off‐axis beam diminution, and 3) the anteroposterior dose profile. Combined radiation therapy and chemotherapy was more effective than either modality alone in the treatment of these failures. Cancer 40:2896‐2904, 1977.
ISSN:0008-543X
1097-0142
DOI:10.1002/1097-0142(197712)40:6<2896::AID-CNCR2820400620>3.0.CO;2-S