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Radiation therapy in the management of early stage Hodgkin's disease presenting in later life
Author(s) -
Zietman A. L.,
Linggood R. M.,
Brookes A. R.,
Convery K.,
Piro A.
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19911101)68:9<1869::aid-cncr2820680903>3.0.co;2-h
Subject(s) - medicine , radiation therapy , disease , stage (stratigraphy) , surgery , laparotomy , retrospective cohort study , paleontology , biology
This study examined the contention that although elderly patients with Hodgkin's disease have a worse prognosis overall than younger patients, a subgroup of older patients fit enough to be managed like younger patients can fare just as well. A retrospective analysis was made on 29 patients older than 60 years of age with Stage I and II Hodgkin's disease treated by radiation therapy alone. Fourteen of these patients were managed optimally, i.e. , were adequately staged (defined by one or more of the following: laparotomy, computed tomography [CT] scan, and/or lymphangiogram), followed by radical radiation therapy (mantle or inverted‐Y). The remaining 15 patients, because of their general medical condition, were managed suboptimally with limited staging and/or involved‐field irradiation. None of the 14 patients managed optimally relapsed over a median of 4.75 years of follow‐up compared with 10 of 15 patients in the suboptimal group. For the optimally managed versus suboptimally managed groups, the actuarial 5‐year disease‐free survival rates were 61% and 6%, respectively; the actuarial overall survival rates (death from all causes) were 61% and 19%, respectively; and the disease‐specific survival rates were 100% and 39%, respectively. Only three of the patients irradiated radically had acute complications severe enough to warrant a break in treatment. In the opinion of the authors, those elderly patients able to tolerate adequate staging and radical radiation therapy can anticipate a high likelihood of cure.