Background & objective: Hodgkin's disease (HD) is a chemo- and radio-sensitive hematologic malignancy. At present, improvement of cure rate, reduction of long-term toxicity, and maintenance of good quality of life are the major issues in the treatment of HD. The results of long term follow-up from Cancer Center, Sun Yat-sen University were analyzed retrospectively in terms of efficacy and late side effects in this article.
Methods: The results of 295 patients with histology-proven HD from 1970 to 2000, especially from 1980 to 2000 were analyzed. Meanwhile, multivariant analysis (COX model) was employed to determine the prognostic factor.
Results: A total of 295 HD patients were treated by chemotherapy-predominant comprehensive modality. The 5, 10, and 20 years overall survival for 295 HD patients were 63.5%, 55.8%, and 47.1%, respectively, with median survival time of 172.3 months (28-351.9 months) at the median follow-up time of 42.9 months (17-351.9 months). The 5, 10, and 20 years overall survival and disease-free survival were 79.6%, 74.5%, and 66.8% as well as 74.5%, 69.4%, and 69.4% respectively for the patients treated with regular chemotherapy and radiotherapy from 1980 to 2000. The incidence rate of late toxicities was low. Multivariate analysis demonstrated that age over 45-year-old, B symptoms and stage III/IV were the main prognostic factors (P = 0.000, P = 0.035, and P = 0.047) in this clinical study. The prognosis of the patients with stage I/II and nodular sclerosis was better in comparison to stages III/IV and other histologic subtypes.
Conclusions: Chemotherapy-predominant combined with involved fields irradiation play an important role in HD treatment with promising long term survival and lower late toxicities. Further investigation for this simplified and convenient comprehensive modality is warranted.