Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
HODGKIN'S DISEASE
Cancer: Principles and Practice of Oncology. Third Edition. DeVita VT Jr. et al, eds. Philadelphia, Lippincott, p. 1696-740, 1989.. Unique Identifier : AIDSLINE ICDB/90666996 Hellman S; Jaffe ES; DeVita VT Jr; Univ. of Chicago, Chicago, IL
Abstract:
Between 7000 and 7500 patients (pts) are diagnosed with Hodgkin's disease (HD) annually in the United States. HD is reviewed under the following headings: etiology and epidemiology; history; pathology (classification, criteria for histologic diagnosis, and cellular origin); natural history (differential diagnosis of lymph nodes; thoracic, abdominal, and other clinical presentations; and disease evolution); diagnosis and staging; complications of staging laparotomy; immunologic abnormalities; radiation therapy; chemotherapy (impact of dose intensity on outcome, selection of treatment for advanced HD, and salvage chemotherapy for advanced HD); treatment of Stage IIIA disease (use of chemotherapy in early-stage disease, HD in AIDS and AIDS-related complex, complications of therapy, and new drugs and biologics); combined radiation and chemotherapy in HD Stages I, II, and III; and current recommendations for treatment of HD by stage. Laparotomy-staged pts with pathologic Stage I and IIA supradiaphragmatic disease and without large mediastinal masses should be treated with mantle radiation. For most pts, para-aortic fields should be included. Clinical Stage I and IIA pts with large mediastinal masses should be spared laparotomy and splenectomy and treated with combination chemotherapy initially, then with radiation to areas of previous bulky disease (mediastinum). Subdiaphragmatic disease is almost invariably diagnosed by laparotomy and should be treated with para-aortic and pelvic irradiation for pelvic or inguinal presentation. Pts with Stage IIB disease may be treated with subtotal nodal radiation. Combined-modality therapy probably should not be used in such pts unless they have large mediastinal disease or their B symptoms do not abate with the mantle radiation therapy field. Pts with clinical Stage IIB disease who have not been evaluated by laparotomy should be treated primarily with chemotherapy, with radiation reserved for sites of previous bulk disease. Radiation therapy alone is not indicated in most Stage III pts; for most Stage III pts, chemotherapy alone is the treatment of choice. Use of radiation therapy should be limited in children because of the risk of retarded bone growth. (427 Refs)
Keywords: Antineoplastic Agents, Combined/THERAPEUTIC USE B-Lymphocytes/PATHOLOGY Combined Modality Therapy Hodgkin's Disease/DRUG THERAPY/PATHOLOGY/RADIOTHERAPY/*THERAPY Human Lymph Nodes/PATHOLOGY Neoplasm Staging T-Lymphocytes/PATHOLOGY MONOGRAPH REVIEW REVIEW, ACADEMIC 901230
M90C3739
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
