PURPOSE: To examine the presentation, management, and outcome of @entity1 with extensive intrathoracic involvement in early-stage @entity978 . @entity1 AND METHODS: One hundred seventy-two @entity1 with clinical Stage IA-IIB @entity978 and extensive intrathoracic involvement were studied. @entity66 was defined as either large mediastinal adenopathy (LMA, defined as the width of the mass greater than one-third the maximum thoracic diameter, n = 154) or as extensive (> 10 cm) cephalocaudad intrathoracic disease that did not fulfill formal chest radiograph criteria for LMA (n = 18). @entity1 were divided into three groups based on staging and extent of treatment. Forty-seven @entity1 were treated with radiation alone after a laparotomy ( @entity138 -lap), 47 @entity1 received combined modality therapy after laparotomy ( @entity33954 -lap), and 78 @entity1 were treated with combined modality therapy without staging laparotomy ( @entity33954 -no lap). MOPP was used in 82% of the @entity33954 @entity1 . Low-dose whole-cardiac @entity138 was used in nearly 50% of @entity1 treated either with @entity138 or @entity33954 . RESULTS: The 10-year actuarial freedom from relapse rates were 54% with @entity138 alone and 88% with @entity33954 (p = 0.001); overall survival rates were 84 and 89%, respectively (p = NS). The median time to relapse was only 17 months. Over 80% of relapses occurred within the first 3 years. The most common site of relapse in all @entity1 was the mediastinum. Relapses below the diaphragm were rare, even in @entity33954 @entity1 who did not receive abdominal radiation treatment. The principal acute morbidity was symptomatic @entity55 , which occurred in 29% of @entity1 receiving any part of their chemotherapy after @entity138 , compared to 13% if all the chemotherapy was given before @entity138 and 11% if @entity138 alone was administered. There was a low late risk of @entity583 (3%) in the two groups with the longest follow up ( @entity138 -lap, @entity33954 -lap), but a higher risk of second @entity5 in the @entity33954 -lap group (21%) compared with the @entity138 -lap group (2%). CONCLUSION: Extensive intrathoracic involvement is a distinctive presentation of early-stage @entity2033 that has a high relapse risk if treated with @entity138 alone. The introduction of @entity33954 has been associated with improvements in freedom from relapse. The low rate of peripheral relapse with @entity33954 suggests that reductions in field size may be achievable. The use of low-dose whole-heart @entity138 with modern techniques is not associated with a high risk of late @entity299 and should be used in @entity1 who present with extensive @entity66 or cardiophrenic lymphadenopathy. The high rate of second @entity5 in the @entity33954 group with the longest follow-up suggests that careful long-term surveillance for such @entity1 is warranted.

Stage IA-IIB XXXX : management and outcome of extensive thoracic involvement.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity33954 :: ('MESH:C537989', 'Disease') :: ['CMT'] @entity66 :: ('MESH:D004194', 'Disease') :: ['Extensive intrathoracic disease', 'pericardial disease'] @entity138 :: ('MESH:C563738', 'Disease') :: ['RT'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonitis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignancy'] @entity2033 :: ('MESH:D006816', 'Disease') :: ['HD'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac complications'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity978 :: ('MESH:D006689', 'Disease') :: ["Hodgkin's disease"]
@entity978 :: (MESH:D006689,Disease) :: ['Hodgkin's disease']
