Radiation therapy of Hodgkin's disease: Significance of splenic involvement

The influence of splenic involvement on disease‐free survival was studied in 83 Hodgkin's disease patients treated with radiation therapy. Patients with splenic disease demonstrated a shorter relapse interval (p = 0.05), more extra‐nodal relapses, and a higher rate of relapses (28% vs. 15%) than patients without splenic involvement. Patients with splenic disease have a 65% probability of disease‐free survival by actuarial analysis at 24 months compared to 79% for all Stage II and III patients without splenic involvement. The additional reduction in disease‐free survival in the group with splenic disease appeared to occur in the first 6 months. The disease‐free survival curves in these groups are parallel beyond 6 months. These data and a retrospective matched pair analysis suggest that a small cohort (15%) of splenic positive patients do poorly with only nodal irradiation because of early extranodal dissemination, but that the majority of these patients may have a prognosis similar to patients with only lymph node disease.