Progress in the treatment of Hodgkin's disease in the United States, 1973 versus 1983. The Patterns of Care Study.

BACKGROUND

The prognosis for Hodgkin's disease patients has improved significantly since the early 1960s. The reasons for this improvement are multifactorial.

METHODS

In the Patterns of Care Study of the American College of Radiology, national surveys to examine process and outcome of patients treated for Hodgkin's disease in 1973 and 1983 were completed. Data were compared for patients who had Stage I-II Hodgkin's disease and who were treated with radiation therapy alone.

RESULTS

Clinical characteristics of the patients in the two different treatment eras were similar. There were important differences in treatment parameters. In 1983 compared with 1973, there was more common use of a dedicated simulator, performance of routine port films, use of linear accelerators, use of individually shaped blocks, and treatment to extended fields. Adequacy of treatment fields also was judged superior in the 1983 study. There were improvements in survival and relapse-free survival for patients treated in 1983 versus 1973.

CONCLUSIONS

Improvement in radiation therapy technique is associated with an improved outcome for patients treated for Hodgkin's disease. The national standards have improved during the time from 1973 to 1983.