Advertisement

Chemotherapy for stage III-A Hodgkin’s disease: The proper role

  • Richard S. Stein
Part of the Cancer Treatment and Research book series (CTAR, volume 16)

Abstract

Despite the availability of results from a large number of clinical trials, therapy of stage III-A Hodgkin’s disease remains a subject of controversy as chemotherapy alone, radiotherapy alone, and combined modality therapy have all been advocated as optimal treatment for patients with stage III-A Hodgkin’s disease. In this paper I will review the data which supports each of these therapeutic recommendations. However, the majority of this paper will review the evidence that there is no one optimal therapy for stage III-A Hodgkin’s disease, and that, instead, anatomic substage — the extent of nodal disease within the abdomen — should be the critical factor in allocating stage III-A Hodgkin’s disease patients to different therapies.

Keywords

Combine Modality Therapy Hepatic Involvement Visceral Dissemination Radiotherapy Port Splenic Involvement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    DeVita VT, Simon RM, Hubbard SM, et al.: Curability of advanced Hodgkin’s disease with chemotherapy. Ann Intern Med 92: 587–595, 1980.Google Scholar
  2. 2.
    Strickland P: Radiotherapy or chemotherapy as the initial treatment for stage IIIA Hodgkin’s disease (Report No. 13). Clin Radiol 32: 527–530, 1981.PubMedCrossRefGoogle Scholar
  3. 3.
    Hoppe RT, Rosenberg SA, Kaplan HS, et al.: Prognostic factors in pathologic stage IIIA Hodgkin’s disease. Cancer 46: 1240–1246, 1980.PubMedCrossRefGoogle Scholar
  4. 4.
    Hoppe RT, Cox RS, roseae Rosenberg SA, Kaplan HS: Prognostic factors in pathologic stage III Hodgkin’s disease. Cancer Treat Rep 66: 743–749, 1982.PubMedGoogle Scholar
  5. 5.
    Stein RS, Golomb HM, Diggs CH, et al.: Anatomic substages of stage III-A Hodgkin’s disease. A collaborative study. Ann Intern Med 92: 159–165, 1980.PubMedGoogle Scholar
  6. 6.
    Stein RS, Golomb HM, Wiernik PH, et al.: Anatomic substages of stage IIIA Hodgkin’s disease: followup of a collaborative study. Cancer Treat Rep 66: 733–741, 1982.PubMedGoogle Scholar
  7. 7.
    Rosenberg SA, Kaplan HS, Glatstein EJ, et al.: Combined modality therapy of Hodgkin’s disease: a report on the Stanford trials. Cancer 42: 991–1000, 1978.PubMedCrossRefGoogle Scholar
  8. 8.
    Coleman CN, Williams CJ, Flint A, et al.: Hematologic neoplasia in patients treated for Hodgkin’s disease. N Engl J Med 297: 1249–1252, 1977.PubMedCrossRefGoogle Scholar
  9. 9.
    Valagussa P, Santoro A, Fossati F, et al.: Absence of treatmentinduced second neoplasms after ABVD in Hodgkin’s disease. Blood 59: 488–494, 1982.PubMedGoogle Scholar
  10. 10.
    Desser RK, Golomb HM, Ultmann JE, et al.: Prognostic classification of Hodgkin’s disease in pathologic stage III, based on anatomic considerations. Blood 49: 883–893, 1977.PubMedGoogle Scholar
  11. 11.
    Levi JA, Wiernik PH: The therapeutic implications of splenic involvement in stage IIIA Hodgkin’s disease. Cancer 39: 2158–2165, 1977.PubMedCrossRefGoogle Scholar
  12. 12.
    Hellman S, Mauch P, Goodman RL, et al.: The place of radiation therapy in the treatment of Hodgkin’s disease. Cancer 42: 971–978, 1978.PubMedCrossRefGoogle Scholar
  13. 13.
    Stein RS, Hilborn RM, Flexner JM, et al.: Anatomical substages of stage III Hodgkin’s disease. Cancer 42: 429–436, 1978.PubMedCrossRefGoogle Scholar
  14. 14.
    DeVita VT, Simon RM, Hubbard SM, et al.: Curability of Advanced Hodgkin’s disease with chemotherapy. Ann of Intern Med 92: 587–595, 1980.Google Scholar
  15. 15.
    Krikorian JG, Portlock CS, Rosenbert SA, et al.: Hodgkin’s disease, stages I and II coae occurring below the diaphragm. Cancer 43: 1866–1871, 1979.PubMedCrossRefGoogle Scholar
  16. 16.
    Griffin T, Gerdes A, Parker R, et al.: Are pelvic irradiation and routine staging laparotomy necessary in clinically staged IA and IIA Hodgkin’s disease? Cancer 40: 2914–2916, 1977.PubMedCrossRefGoogle Scholar
  17. 17.
    Johnson RE, Zimbler H, Berard CW, et al.: Radiotherapy results for nodular sclerosing Hodgkin’s disease after clinical staging. Cancer 39: 1439–1444, 1977.PubMedCrossRefGoogle Scholar
  18. 18.
    Desser RK, Moran EM, Ultmann JE: Staging of Hodgkin’s disease and lymphoma: diagnostic procedures including staging laparotomy and splenectomy. Med Clin N Am 57: 479–498, 1973.PubMedGoogle Scholar
  19. 19.
    Aisenberg AC, Goldman JM, Baker JW, et al.: Spleen involvement at the onset of Hodgkin’s disease. Ann Intern Med 74: 544, 1971.PubMedGoogle Scholar
  20. 20.
    Farrer-Brown G, Bennett MH, Harrison CV, et al.: Pathological findings following laparo-tomy in Hodgkin’s disease. Br J Cancer 25: 499, 1971.CrossRefGoogle Scholar
  21. 21.
    Glatstein E, Guernsey JM, Rosenberg SA, et al.: The value of laparotomy and splenectomy in the staging of Hodgkin’s disease. Cancer 24: 709, 1969.PubMedCrossRefGoogle Scholar
  22. 22.
    Glatstein E, Trueblood HW, Enright LP, et al.: Surgical staging of abdominal involvement in unselected patients with Hodgkin’s disease. Radiology 97: 425, 1970.PubMedGoogle Scholar
  23. 23.
    Hanks GE, Newsome JF, Lewis NT: The value of laparotomy in staging lymphomas. South Med J 64: 585, 1971.PubMedCrossRefGoogle Scholar
  24. 24.
    Lowenbraum S, Ramsey H, Sutherland J, et al.: Diagnostic laparotomy and splenectomy for staging Hodgkin’s disease. Ann Intern Med 72: 655, 1970.Google Scholar
  25. 25.
    Prosnitz LR, Nuland SB, Kiligerman MM: Role of laparotomy and splenectomy in the management of Hodgkin’s disease. Cancer 29: 44, 1972.PubMedCrossRefGoogle Scholar
  26. 26.
    Fialk MA, Jarowski CI, Coleman M, Mouradian J: Hepatic Hodgkin’s disease without involvement of the spleen. Cancer 43: 1146–1147, 1979.PubMedCrossRefGoogle Scholar
  27. 27.
    Prosnitz LR, Montalvo RL, Fischer DB, et al.: Treatment of stage IIA Hodgkin’s disease: Is radiotherapy alone adequate? Int J Radiat Oncol Biol Phys 4: 481–787, 1978.Google Scholar

Copyright information

© Martinus Nijhoff Publishers, Boston. 1983

Authors and Affiliations

  • Richard S. Stein

There are no affiliations available

Personalised recommendations