January 1, 1973

Updated Hodgkin's Disease: B. Curability of Localized Disease

JAMA. 1973;223(1):49-50. doi:10.1001/jama.1973.03220010035008

The ability of irradiation to cure localized Hodgkin's disease and lymphomas is beyond debate. The problem is to determine in which patients the apparently localized disease is truly confined to the nodal sites. The current controversy in therapeutic management of localized Hodgkin's disease with radiation is whether it is preferable to treat selected sites only, or most of the lymph nodes and lymphoid tissue on both sides of the diaphragm. An elaborate diagnostic work-up that includes pedal lymphangiography, laparotomy, splenectomy, biopsies of the lymph node and liver, scanning the bone and bone marrow, and biopsy of the bone marrow may yield information pertinent to this decision. Careful documentation of patterns of recurrence after utilizing various field arrangements and effective doses of radiation therapy is also important. The primary therapeutic decision in Hodgkin's disease rests on the oncologist's estimation of the difference between the initial clinical appearance of the extent of