Results of lung irradiation for Hodgkin's disease patient with large mediastinal masses and/or hilar disease.

From 1970 to 1979, 130 patients with Hodgkin's disease were seen at the University of Minnesota and were treated with curative radiotherapy following surgical staging. Thirty-nine of the 130 patients had large mediastinal masses. Twenty patients with large mediastinal masses treated before 1975 received regular mantle-field irradiation. Our treatment technique was modified in 1975 because of frequent recurrences in the intrathoracic region in these patients. Between 1975 and 1979, patients with large mediastinal masses were treated with low-dose lung irradiation as an initial part of the mantle field treatment. Nineteen patients were treated in this manner, and 16 of these 19 have been followed for greater than 24 months. Only one of the 16 patients has had a recurrence in the lung. We have not seen any serious acute of subacute pulmonary or cardiac complications after low-dose lung irradiation. The followup period is still too brief for the study of late complications. Analysis of four results with lung irradiation reveals excellent control of large mediastinal masses and significantly improved recurrence-free survival.