Blocking considerations in mantle therapy

Extended field radiation therapy in Hodgkin's disease: analysis of failures

A retrospective analysis of 116 primary cases of stage I, II and III-A Hodgkin's disease demonstrated 27 failures, fourteen confirmed by biopsy. Twenty of the 27 (74%) were in lymph node areas only and seven had extranodal extensions. The most frequent site of failure was the hilar nodes and contiguous lung. The majority of failures (78%) occurred within 30 months of treatment and the cause of failure determined in 23 (85%), sixteen of which were due to technical errors of irradiation. Analysis of the dosimetry in the mediastinal, hilar nodes and contiguous lung failures revealed three factors which may have contributed to a low dose. These factors are: 1) the equivalent square, 2) off-axis beam diminution, and 3) the anteroposterior dose profile. Combined radiation therapy and chemotherapy was more effective than either modality alone in the treatment of these failures.

Mantle treatment of Hodgkin's disease. Results and side effects

Eighty-seven patients were treated with the mantle technique for Hodgkin's disease. Usually 40 Gy in 27 fractions in two series over 71 days were given. A local recurrence was diagnosed in 3 of 87 patients. An analysis of radiation reactions of the lung tissue, heart and pericardium, and spinal cord is reported. It is recommended to give mantle treatment for Hodgkin's disease over a relatively long period of time such as in split-course in two series.