Controversies in curability of Hodgkings disease

Similar results were obtained in curability (90%) with the use of radiotherapy, chemotherapy and the combination of both, in patients with localized stages(I-II) without adverse risk factors, like bulky disease, multiple lymph node areas,presence of symptoms or older age. Excellent results in curability (80%) were achieved with the combined modality of radiotherapy and chemotherapy in localized stages with adverse factors, and superior to both modalities used alone. Radiotherapy is inferior than chemotherapy in disseminated stage (III-IV). Regimens with antracyclines, like ABVD, are superior than those without antracyclines, like MOPP. The combination of chemotherapy and radiotherapy, specially in stages III, are used with excelent results and without differences according to the chemotherapy schemes used. Dose intensity administration is the main prognostic factor in achieving high rate complete remission and events-free-survival. Maintenance treatment is not useful. Autologous bone marrow transplantation and peripheral blood stem cell are used in patients who achieved second remission and in those patients with first complete or partial remission with adverse risk factors like ''bulky'' tumoral masses or multiple extranodal areas. Poor results were obtained with transplant in refractory patients with disease progression under chemotherapy. (Author)