study of different treatment therapy in the early stage of Hodgkin's disease of upper diaphragms in North East of Iran

ABSTRACT

The proper treatment for early-stage Hodgkin's disease is controversial. The purpose of this study was to evaluate the therapeutic outcomes of various treatment strategies in supradiaphragmatic clinical early-stage Hodgkin's disease. This retrospective study reviewed the medical records of 105 eligible patients [49 stage I, 59 stage II] who were treated at radiotherapy- oncology departments of Qaem and Omid hospitals in Mashhad [Iran] from April 1995 to April 2000. 26 patients had B symptoms and 5 had large mediastinal mass. Treatment of patients consisted of chemotherapy alone [43 cases], radiotherapy alone [46 cases, 40 mantle and 6 Total nodal irradiation] and combined modality [16 cases]. Survival rates were calculated by Kaplan- Meier model. Log-rank test was used to compare the survival profile between groups. The median age of patients was 25 years with a male to female ratio of 1.56 1. In comparison with radiotherapy only group, Primary chemotherapy and combined modality groups had significantly more cases with unfavorable factors such as B symptoms, Large mediastinal mass, ESR>40 and stage II. For chemotherapy, combined modality and radiotherapy groups the 5-year progression free survival was 72.5%, 82.5% and 56.2% [P<0.05] and the 5-year disease specific survival was 82.9%, 91.6% and 82.5% respectively. Despite having more cases with unfavorable factors, patients who underwent chemotherapy or combined treatment had lower relapse rates compared to radiotherapy only group. However, there was not a significant difference in 5-year disease specific survival rates between these groups