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American Journal of Roentgenology, Vol 102, 613-618, Copyright © 1968 by American Roentgen Ray Society

A STUDY OF SURVIVAL IN 279 CASES OF HODGKIN'S DISEASE

CARL W. BOYER JR. 1, THEODORE J. BRICKNER JR. 1, and RONALD H. PERRY 1

1 From the Radiation Therapy Section, Radiology Service, Walter Reed General Hospital, Walter Reed Army Medical Center. Washington, D. C.

The series of cases of Hodgkin's disease treated at Walter Reed General Hospital during the interval between 1949 and 1961 is presented and the results of treatment are analyzed and compared with other series. The limited value of using over-all survival figures to measure success of treatment is demonstrated. Differences in survival by stage evident in this comparison are discussed.

In the Walter Reed General Hospital series there was apparent improvement in survival in the early stages when prophylactic areas were irradiated. With the present staging system there may be little value in differentiating between Stage 1 and 11A since survival at 5 and 10 years is the same in each stage. The system proposed at the Symposium on the Radiotherapy of Hodgkin's disease9 recognizes this difficulty and redefines Stage 1 as "disease limited to one anatomic region or two contiguous anatomic regions on the same side of the diaphragm."

Supervoltage equipment has made it possible to irradiate larger volumes of tissue to higher doses than was possible in the orthovoltage era, and possibilities for cure in the earlier stages are better than before. It is reasonable to hope that survival in the later Stages may eventually be improved using irradiation as the primary modality of treatment. Prospective studies are now in progress in several centers to determine the proper time-dose-volume relationship in all stages of the disease.

The most important prognostic feature in Hodgkin's disease is the extent of disease evident when the patient presents himself for treatment. When there is localization of disease to the lymphatic regions on one side of the diaphragm, survival free of disease can be expected using properly directed radiation therapy. There is little doubt that any disease which falls within the radiation beam can be completely and permanently sterilized. The climate today regarding this disease is one of optimism leaving no room for the fatalistic approach which denies the patient his chance for cure.


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Copyright © 1968 by the American Roentgen Ray Society.