National survey of patterns of care for Hodgkin's disease

Abstract

Patterns of care for Hodgkin's disease were surveyed through voluntary audits of hospitals with cancer programs approved by the Cancer Commission of the American College of Surgeons. Four hundred seventy-three hospitals reported 6314 patients in the long-term survey (patients diagnosed immediately preceding December 31, 1975), and 611 hospitals identified 3168 new patients in the short-term study (patients diagnosed immediately following January 1, 1981). The latter represent 45% of the estimated annual incidence in the United States. Comparison of the two studies showed changes in the procedures employed in staging, including an increased use of lung and abdominal computed tomography and bilateral bone marrow biopsies. Use of upper mantle plus periaortic node radiotherapy increased, whereas the inverted-Y field decreased. The use of single-agent chemotherapy decreased, and MOPP (nitrogen mustard, vincristine, procarbazine, and prednisone) chemotherapy increased. The survival rates varied with age, being better at younger ages and worse in the elderly.

Outcome of children with resistant and relapsed Hodgkin's disease

“…Whilst factors predictive of relapse in both adults (Kennedy et al, 1985) and children (Mauch et al, 1983;Robinson et al, 1984;Russell et al, 1984) …”

“…The overall 5-year survival rate in this age group (all stages) is in excess of 80%. This figure falls with increasing age to less than 40% for those over 65 years at diagnosis (Kennedy et al, 1985). Whilst factors predictive of relapse in both adults (Kennedy et al, 1985) and children (Mauch et al, 1983;Robinson et al, 1984;Russell et al, 1984) (Robinson et al, 1984 (Kaye et al, 1979).…”

Second primary malignancy after Hodgkin's disease, ovarian cancer and cancer of the testis: A population-based cohort study

“…Chemotherapy has been used particularly for the treatment of Hodgkin's disease (McVie & Somers, 1985;Kennedy et al, 1985) and cancers of the ovary (Reimer et al, 1977) and testis (Newlands et al, 1983).…”

Outcome of a risk-related therapeutic strategy used prospectively in a population-based study of Hodgkin's lymphoma in adolescents

“…Among older patients with HL, it has been repeatedly demonstrated that the survival data in populationbased studies are poorer than those from clinical trials (Kennedy et al, 1985;Appleton et al, 1995;Clarke et al, 2001;Proctor et al, 2002;Jarrett et al, 2005). This effect is likely to be due, at least in part, to the exclusion of frailer elderly individuals from clinical NLPHD (n=7) cHL (n=48) NLPHD ( (Hudson et al, 1993(Hudson et al, , 2004Hutchinson et al, 1998;Friedmann et al, 2002).…”

“…In these countries, the incidence of the disease is very low in young children, peaks in young adults, wanes in middle age then gradually increases again over the later decades (Kennedy et al, 1985;Armstrong et al, 1994). During the teenage years there is a steep rise in the incidence of HL, culminating in the peak incidence described in the third decade.…”