Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.

  • Authors:
    • B Cutuli
    • T Petit
    • S Hoffstetter
    • M Velten
    • P Dufour
    • C Giron
    • P Lederlin
    • G M Jung
    • J P Bergerat
    • F Maloisel
    • P Bey
    • F Oberling
  • View Affiliations

  • Published online on: November 1, 1998     https://doi.org/10.3892/or.5.6.1513
  • Pages: 1513-1521
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Abstract

To evaluate the results, prognostic factors and especially side-effects of the treatment for subdiaphragmatic Hodgkin's disease (SHD) a retrospective study was conducted in the Haematology Departments and in the Cancer Centres of Nancy and Strasbourg between 1976 and 1990; 55 patients corresponding to the IA to IIB SHD stages were analysed. The median age was 45 years. In accordance with Ann Arbor classification, we observed 12 CS IA (21.3%), 2 CS IB (3.5%), 14 CS IIA (25.4%) and 27 CS IIB (49.7%). Twenty-five patients (45.4%) underwent laparotomy with spleen involvement in 10 cases. Fifteen patients (27.3%) had exclusive radiotherapy, 10 by inverted-Y field with or without splenic field, 5 by limited field to inguinal and homolateral iliac nodes. Forty patients had prior chemotherapy, 18 by MOPP protocol, 18 by hybrid MOPP/ABVD protocol and 4 by other schemes. The total dose delivered ranged from 26 to 45 Gy. With a median follow-up of 8 years, the overall and disease specific survival rates are respectively 61% and 83% at 10 years. Nine patients relapsed (16.4%), 4 among the 15 (26.6%) treated by exclusive irradiation and 5 among the 40 (12.5%) treated by combined therapy. We observed 8.3%, 21.4% and 18.5% of relapses respectively among the clinical stages IA, IIA and IIB. Eleven patients (20%) developed a second cancer. Twenty-six long-term complications were noted, nine of which concerned the digestive system. The only significant prognostic factor is age, with 10-year specific survival rates of 96% and 66% respectively for patients younger and older than 50 years (p=0.0003). Our data confirm that the most appropriate treatment for stage IA is exclusive radiotherapy and combined therapy for all other cases. With the use of CT-scan and eventually lymphography, the laparotomy is reserved only for cases with an uncertain diagnosis. Tobacco use is also clearly a risk factor in our series for late vascular complications and second cancers.

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Nov-Dec 1998
Volume 5 Issue 6

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Online ISSN:1791-2431

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Spandidos Publications style
Cutuli B, Petit T, Hoffstetter S, Velten M, Dufour P, Giron C, Lederlin P, Jung G, Bergerat J, Maloisel F, Maloisel F, et al: Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.. Oncol Rep 5: 1513-1521, 1998
APA
Cutuli, B., Petit, T., Hoffstetter, S., Velten, M., Dufour, P., Giron, C. ... Oberling, F. (1998). Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.. Oncology Reports, 5, 1513-1521. https://doi.org/10.3892/or.5.6.1513
MLA
Cutuli, B., Petit, T., Hoffstetter, S., Velten, M., Dufour, P., Giron, C., Lederlin, P., Jung, G., Bergerat, J., Maloisel, F., Bey, P., Oberling, F."Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.". Oncology Reports 5.6 (1998): 1513-1521.
Chicago
Cutuli, B., Petit, T., Hoffstetter, S., Velten, M., Dufour, P., Giron, C., Lederlin, P., Jung, G., Bergerat, J., Maloisel, F., Bey, P., Oberling, F."Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.". Oncology Reports 5, no. 6 (1998): 1513-1521. https://doi.org/10.3892/or.5.6.1513