Radiation therapy for pathologic stage III Hodgkin's disease with and without chemotherapy

Ninety-eight patients with pathological Stage (PS) III Hodgkin's disease treated between 1969 and 1984 were retrospectively analyzed. Treatment consisted of radiation therapy (RT) alone in 46 patients and combined radiation therapy and chemotherapy (CMT) in 52 patients. The median follow-up was 10 years (range 3-19 years). Fifteen-year survival for patients with Stage III₁ is better than for Stage III₂ patients (82% vs 53%; p = .014). Patients with Stage III₁A have a favorable prognosis regardless of treatment modality. The probability of freedom from relapse at 15 years for patients with pathological Stage III₁A treated with radiation therapy is 70%, compared to 83% for pathological Stage III₁A patients treated with combined modality therapy (p = .56). In patients with pathological Stage III₂A, III₁B, and III₂B relapses were less frequent with the use of combined modality therapy compared to radiation therapy. We conclude that pathological Stage III₁A patients may be treated with radiation therapy alone; the other subsets of patients benefit from combined radiation and chemotherapy.