One hundred forty-nine supradiaphragmatic Stage IA and IIA @entity978 ( @entity978 ) @entity1 treated according to one of two different policies, were analyzed to quantitate the therapeutic gains achieved in recent years. Forty-nine @entity1 were managed according to the pre-1969 policy consisting of mantle radiotherapy (XRT) only without laparotomy staging and without subdiaphragmatic treatment. These cases constitute the @entity4536 ( @entity4536 ). Ninety-eight @entity1 after 1969 received staging laparotomy-splenectomy and were treated with @entity512 , and in a small number also multiagent chemotherapy (MAC). These @entity1 constitute the @entity6025 ( @entity6025 ). All prelaparotomy IA and IIA cases are included in the @entity6025 even if they became Stage III at laparotomy. Salvage therapy for relapsing disease differed between the @entity4536 and @entity6025 . The majority of @entity4536 relapsing @entity1 received salvage XRT, while the majority of relapsing @entity6025 @entity1 received MAC. The @entity6025 and @entity4536 @entity1 groups are comparable by pretreatment parameters. There is a large and statistically significant improvement in disease-free survival (DFS) and survival (S) in the @entity6025 over the @entity4536 . At 13 years the @entity6025 group had a DFS of 65% compared to 38% in the @entity4536 , and S in the @entity6025 was 82% compared to 37% in the @entity4536 . The improvement in DFS is almost totally due to the addition of prophylactic periaortic XRT in the @entity6025 @entity1 . A striking reversal of relapse patterns for the @entity4536 and @entity6025 was observed. Periaortic nodal relapse occurred in 37% of the @entity4536 @entity1 and accounted for 64% of all relapses, while in the @entity6025 this failure pattern occurred in only 2% of all cases. Supradiaphragmatic relapse accounted for 74% of all relapses in the @entity6025 . Improved salvage of relapsed @entity1 in the @entity6025 further added to the overall gain in survival. Whereas no relapsed @entity1 in the @entity4536 achieved long-term survival (14% at 10 years, 0 at 25 years), one-half of @entity6025 relapses were salvaged by MAC (54% survival at 10 years from relapse). These data clearly document the striking therapeutic gains in Stage IA and IIA supradiaphragmatic @entity978 resulting from the use of prophylactic periaortic XRT and MAC salvage for relapsing @entity1 .

XXXX stages IA and IIA. A long-term follow-up study on the gains achieved by modern therapy.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity4536 :: ('MESH:D016773', 'Disease') :: ['OS', 'old series'] @entity512 :: ('MESH:C567308', 'Disease') :: ['total or subtotal nodal irradiation'] @entity978 :: ('MESH:D006689', 'Disease') :: ['HD', "Hodgkin's disease"] @entity6025 :: ('OMIM:303800', 'Disease') :: ['new series', 'NS']
@entity978 :: (MESH:D006689,Disease) :: ['Hodgkin's disease']
