Patterns of care outcome studies in Hodgkin's disease: results of the national practice and implications for management.

In a statistically valid random sample of 387 patients selected from the national practice and treated with radiation therapy in 1973 for Hodgkin's disease, the 4-year recurrence-free survival was: stage IA, 82%; stage IIA, 75%; stage IIIA. 60%; and combined stages IB-IIIB, 50%. Observations of in-field recurrence in 996 separate lymph node areas show no dose-response relationship between 3000 and 5000 rad. The use of chemotherapy in stage IIIA Hodgkin's disease in the national practice is associated with a significant improvement in recurrence-free survival (P = 0.01). A group of 51 patients with stages IA-IIIA Hodgkin's disease, aged 5-15, treated with radiation therapy alone, has a 92% recurrence-free rate at 3 years with no major complications.