HODGKIN'S DISEASE TREATED WITH RADIATION THERAPY: FOLLOW-UP DATA AND THE VALUE OF LAPAROTOMY

During the years 1958-1969, 123 patients with Stage I, II and IIIA Hodgkin's disease were treated with radical radiation therapy in the Department of Radiation Therapy at the Yale-New Haven Hospital. The cumulative survival of Stage I and II patients was 72 per cent at 5 years counting all patients and 54 per cent including only those patients living and free of disease. Reactivations of disease occurred in 50 per cent of patients and were associated with a poor prognosis. Ninety per cent of patients who relapsed are either living with disease or dead.

In order to improve the staging accuracy and subsequent therapy, exploratory laparotomy was begun in January 1969. Forty untreated, newly diagnosed patients have undergone this procedure in 1969 and 1970. Of 26 patients with Stage I and II disease by all criteria except surgery, 7 proved to have abdominal disease following surgery. In addition, a high degree of splenic involvement that was unsuspected clinically has been found. These results suggest that Hodgkin's disease may be a more generalized disorder in certain patients. Further improvement in survival may require the use of even more extensive treatment fields than have been customary.

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