Abstract
In the last 8 years, 12 clinical stage (CS) I-II patients received total nodal irradiation (TNI) or subtotal nodal irradiation (STN), 6 of whom underwent staging laparotomy. Other 6 CS I-II patients had mantle field irradiation (MA). Before referring us, two patients with TNI or STN had chemotherapy of small doses, but they showed no response. All 6 patients with MA also received chemotherapy of small doses. Laparotomy showed 2 patients had upper abdominal disease, resulting in changes of their radiation fields. Planned irradiation schedules could be performed safely in all 18 patients. After completion of irradiation, they have been followed up for 10∼96 months without severe late complications. Of the 12 patients with TNI or STN, only one with multiple splenic involvements has experienced relapse, well within the radiation fields. He has achieved complete remission again using C-MOPP, and is alive and well as of this writing. On the other hand, three of the 6 patients with MA relapsed mainly outside the radiation fields, two of whom have died of disease. We conclude that large field irradiation such as TNI or STN is feasible to perform, and will improve relapse free survival of Japanese patients with Hodgkin's disease. Staging laparotomy is also feasible, and plays an important role to increase cure rates and decrease treatmemt morbidity.
