Systematic restaging in patients with Hodgkin's disease. A southwest oncology group study

✍ Scribed by Terence S. Herman; Stephen E. Jones

• Publisher: John Wiley and Sons
• Year: 1978
• Tongue: English
• Weight: 653 KB
• Volume: 42
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(197810)42:4<1976::aid-cncr2820420442>3.0.co;2-n

✦ Synopsis

Eighty-two patients with advanced Hodgkin's disease who were in apparent complete remission (CR) after receiving 10 courses of combination chemotherapy were systematically reevaluated for persisting disease. Occult Hodgkin's disease was found in 10 (12%) of these patients and was predominantly present in nodal sites (91%) which were known to have been involved at initial staging (100%). Repeat chest radiography, Gallium-67 tumor scanning and lymphography were the most helpful procedures for detecting residual disease. Nine of the 72 (13%) patients felt to be free of disease after negative restaging subsequently relapsed within 8 months. Sites of early relapse, like the sites of disease found at restaging, occurred almost always in previously involved nodal areas. We conclude that systematic restaging should be incorporated into subsequent lymphoma trials in order to define more clearly complete remission and that every patient treated for lymphoma should undergo a careful restaging evaluation before therapy is discontinued.

Cancer 42:1976-1982, 1978.

N ANIMALS THE TIME to recurrence after I removal of gross tumor is directly proportional to the number of remaining tumor cells.28 It appears that this phenomenon is also valid in human cancer and has been a part of the rationale for adjuvant chemotherapy.24 Treatment of advanced lymphomas with combination chemotherapy is now capable of reducing the number of cancer cells below the clinically detectable level in the majority of cases. A significant number of patients in apparent complete remission, however, develop recurrent disease, usually within 2 years after cessation of treatment.5'6j21,25 This pattern of relapse suggests that a considerable number of malignant cells remain in these patients at the time when treatment is discontinued and that the detection of residual lymphoma should be possible in many cases