Long term remissions with combined modality therapy for advanced Hodgkin's disease

Theoretical considerations underlying CRT have been presented. CRT is usually given when disseminated disease is known to be present (e.g., Stage IV Hodgkin's disease) or the risk of dissemination is extremely high (e.g., Stage IIIB Hodgkin's disease, or limited small cell carcinoma of the lung). The effectiveness of chemotherapy declines with increasing numbers of cells. Even if CR is obtained, relapse at sites of prior bulk disease may be anticipated in a significant percentage of patients, even those having the most sensitive tumors. Therefore, limited irradiation to these areas may be of value in decreasing the relapse rate and increasing the cure rate. This approach has been the most useful in advanced Hodgkin's disease where the cure rates are approximately 70% with CRT