Cure of Hodgkin's Disease

Easson, E. C.; Russell, Marion H.

doi:10.1136/bmj.1.5347.1704

Cited by 172 publications

(20 citation statements)

References 4 publications

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“…In 1963, Easson and Russell also suggested that Hodgkin disease could be cured with radiotherapy. 3 As radiotherapy techniques were refined, radiotherapy alone became the standard treatment in the 1960s for early-stage Hodgkin disease. 4 However, it became apparent in the 1970s and 1980s that, compared with the general population, patients cured of Hodgkin disease with radiotherapy were at increased risk of second malignancies.…”

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confidence: 99%

Second Malignancies After Chemotherapy and Radiotherapy for Hodgkin Disease

Chronowski¹,

Wilder²,

Levy³

et al. 2004

American Journal of Clinical Oncology

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The purpose of this preliminary study was to determine the incidence of second malignancies after combined-modality therapy for adults with Hodgkin disease and relate it to the details of initial treatment. We retrospectively studied 286 patients ranging in age from 16 to 88 years with stage I or II Hodgkin disease who were treated between 1980 and 1995 with chemotherapy followed 3 to 4 weeks later by radiotherapy. Patients received a median of three cycles of induction chemotherapy. Mitoxantrone, vincristine, vinblastine, and prednisone was used in 161 cases, mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) in 67 cases, Adriamycin, bleomycin, vinblastine, and dacarbazine in 19 cases, lomustine, vinblastine, procarbazine, and prednisone/doxorubicin, bleomycin, dacarbazine, and lomustine in 18 cases, and other chemotherapeutic regimens in the remaining 21 cases. The median radiotherapy dose was 40 Gy given in 20 daily 2-Gy fractions. Median follow-up of surviving patients was 7.4 years. There were 2,230 person-years of observation. Significantly increased relative risks (RR) were observed for acute myeloid leukemia (RR, 69.3; 95% CI, 14.3-202.6) and melanoma (RR, 7.3; 95% CI, 1.5-21.3). The 5-, 10-, and 15-year actuarial risks of acute myeloid leukemia were 0.8%, 1.3%, and 1.3%, respectively. Patients treated with MOPP had the highest 15-year actuarial risk of leukemia (1.6%). The 5-, 10-, and 15-year actuarial risks of solid tumors were 1.9%, 9.3%, and 16.8%, respectively. Consolidative radiotherapy to both sides of the diaphragm resulted in a trend toward an increased risk of solid tumors relative to radiotherapy to only one side of the diaphragm (p = 0.08). In an effort to reduce the risk of second malignancies, we have stopped using the alkylating agents nitrogen mustard and procarbazine and elective paraaortic and splenic radiotherapy after chemotherapy.

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confidence: 99%

Second Malignancies After Chemotherapy and Radiotherapy for Hodgkin Disease

Chronowski¹,

Wilder²,

Levy³

et al. 2004

American Journal of Clinical Oncology

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“…This view was supported by Gilbert (1939), Craft (1940), Peters (1950Peters ( , 1958, Easson (1963), and particularly reinforced by Kaplan (1962), such that extended field megavoltage radiotherapy, has become the accepted treatment of choice, for patients with localised HD to this present day. The techniques available for determining the extent of HD have improved considerably during the past thirty years, with lymphangiography and latterly computerised axial tomography (CAT) for delineating intra-abdominal lymph nodes, and laparotomy in selected instances for detecting splenic and hepatic involvement.…”

mentioning

confidence: 69%

Radiotherapy for stage I Hodgkin's disease: 20 years experience at St Bartholomew's Hospital

Ganesan

Wrigley²,

Murray³

et al. 1990

Br J Cancer

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“…1970, STRUM & RAPPAPORT 1971. It is well known, however, that recurrences of Hodgkin's disease may occur later and reports on 15-year survivors may therefore be rewarding; only a few such reports have appeared (SLAUGHTER & CRAVER 1942, BICHEL 1955, EASSON & RUSSEL 1963, MUSSHOFF & BOUTIS 1968, SMETANA 1969 .…”

Section: Fifteen-year Survivors In Hodgkin's Diseasementioning

confidence: 99%