The study of different treatment therapy in the early stage of Hodgkin's disease of apper diaphragms in noth-east of Iran

The proper treatment for early-stage Hodgkin’s disease is controversial. The purpose of this study was to evaluate the therapeutic outcomes of various treatment strategies in supradiaphragmatic clinical early-stage Hodgkin’s disease. This retrospective study reviewed the medical records of 105 eligible patients (49 stage I, 59 stage II) who were treated at radiotherapy- oncology departments of Qaem and Omid hospitals in Mashhad (Iran) from April 1995 to April 2000. 26 patients had B symptoms and 5 had large mediastinal mass. Treatment of patients consisted of chemotherapy alone (43 cases), radiotherapy alone (46 cases, 40 mantle and 6 Total nodal irradiation) and combined modality (16 cases). Survival rates were calculated by Kaplan- Meier model. Log-rank test was used to compare the survival profile between groups. The median age of patients was 25 years with a male to female ratio of 1.56: 1. In comparison with radiotherapy only group, Primary chemotherapy and combined modality groups had significantly more cases with unfavorable factors such as B symptoms, Large mediastinal mass, ESR>40 and stage II. For chemotherapy, combined modality and radiotherapy groups the 5-year progression free survival was 72.5%, 82.5% and 56.2% (P<0.05) and the 5-year disease specific survival was 82.9%, 91.6% and 82.5% respectively. Despite having more cases with unfavorable factors, patients who underwent chemotherapy or combined treatment had lower relapse rates compared to radiotherapy only group. However, there was not a significant difference in 5-year disease specific survival rates between these groups.