[Present state of the wide-field megavoltage radiotherapy of Hodgkin's disease. Fundamentals, performance, side effects (author's transl)].

Therapeutic results of Hodgkin's disease could be significantly improved by the introduction of megavoltage radiotherapy equipment and more profound knowledge about this disease. By this way, five year survival rates of 70% can be achieved for all stages and up to 100% for the early stages. The wide field technique enables the coverage of all lymph nodes with protection of non involved organs. Simultaneously, these improved technical conditions make optimal radiation planning necessary which demands numerous technical auxiliaries. Radiation type and radiation energy are important preconditions for the therapy; production and usage of shilding blocks are necessary for individual performance. The principle for optimal radiation dose distribution are measurements and calculations on the phantom which are now included in computer programs. Nevertheless, radiation of large volumes represent a high stress for the patient. Despite the improvement of the therapeutic results there are except the acute radiation side effects, also irreversible alterations. These can be analysed only after long time observations and has to be balanced with the therapeutic results. The knowledge of these side effects is very important for the radiologist. Beside that, the risk of induction of a second tumor has to be considered. The present possibilities of absolute control of this disease enables the overtreatment of lesions in the early stages. Therefore it has to be postulated to regard the present therapy concepts with attention and to consider the possible side effects.