Supradiaphragmatic Hodgkin's disease: significance of large mediastinal masses
In order to assess the significance of large mediastinal masses in patients with Hodgkin's disease, we analyzed all patients with pathological stage (PS) IA or IIA disease evaluated and treated at Yale between 1969 and 1978. There were 131 such patients treated initially with radical radiotherapy only, combination chemotherapy being reserved for those who failed radiation. Actuarial 5 and 10 year survivals were 95%. The presence of a mediastinal mass regardless of size did not affect survival. Relapse-free survival was 77% at 5 years, 74% at 10 years in the entire group. Patients with any mediastinal involvement had a 65% relapse-free survival, 72% if the mass was < 33% of transverse chest diameter, 55% if the mass was > 33%. These differences are suggestive of a greater tendency of such patients to fail radiotherapy but the differences were not statistically significant. Patients who did fail radiotherapy were for the most part successfully retreated with combined modality therapy (chemotherapy and radiation), accounting for the most part successfully retreated with combined modality therapy (chemotherapy and radiation), accounting for the overall survival of 95%. Only 6 patients died of causes related to Hodgkin's disease and 2 of these deaths were related to combined modality therapy complications. Because of the serious potential long term consequences of combined modality treatment, it should be used with great caution and on an individual basis only in PSIA and IIA patients.
- Research Organization:
- Yale Univ. School of Medicine, New Haven, CT
- OSTI ID:
- 6854561
- Journal Information:
- Int. J. Radiat. Oncol., Biol. Phys.; (United States), Vol. 6:7
- Country of Publication:
- United States
- Language:
- English
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63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
59 BASIC BIOLOGICAL SCIENCES
HEART
BIOLOGICAL RADIATION EFFECTS
HODGKINS DISEASE
LUNGS
RADIOTHERAPY
SIDE EFFECTS
THYROID
COBALT 60
HYPOTHYROIDISM
INFLAMMATION
LINEAR ACCELERATORS
MEDIASTINUM
PATIENTS
PNEUMONITIS
RADIATION DOSES
RADIOINDUCTION
SURVIVAL TIME
VOLUME
ACCELERATORS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BODY
BODY AREAS
CARDIOVASCULAR SYSTEM
CHEST
COBALT ISOTOPES
DISEASES
DOSES
ENDOCRINE DISEASES
ENDOCRINE GLANDS
GLANDS
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LYMPHOMAS
MEDICINE
MINUTES LIVING RADIOISOTOPES
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANS
PATHOLOGICAL CHANGES
RADIATION EFFECTS
RADIOISOTOPES
RADIOLOGY
RESPIRATORY SYSTEM
SYMPTOMS
THERAPY
YEARS LIVING RADIOISOTOPES
550603* - Medicine- External Radiation in Therapy- (1980-)
560151 - Radiation Effects on Animals- Man
551000 - Physiological Systems