Chemotherapy of Hodgkin's disease

Radiotherapy has the first priority in planning an appropriate therapeutic program for the patient with Hodgkin's disease but chemotherapy also has acquired an important role. Drugs which have demonstrated therapeutic activity in Hodgkin's disease include: polyfunctional alkylating agents, vinca alkaloids, N‐methylhydrazine, adrenal steroids and actinomycin D. The antimetabolites have been less successful; an irregular and brief effect is reported for methotrexate and generally no benefit at all from 6‐mercaptopurine and 5‐fluorouracil. The indications for drug therapy include: (1) localized Hodgkin's disease in combination with x‐ray therapy; (2) in acute situations when rapid relief of signs or symptoms are necessary and (3) for widespread disease with systemic manifestations. There are no certain guides to the choice of drug or regimen and the therapeutic program in each case must be adapted to the patient and to the treatment modalities available.