Factors influencing survival in patients with Hodgkin's disease

Survival in Hodgkin's disease depends on the type of tumour developed, on the immune disorder associated with it, on the extent of spread by the time treatment starts, and on the treatment given. Treatment for this disease was ineffective until. radiotherapy began to come into general use in the 1920's; progress was made in the 1940's, but there was little further advancement until the early 1960's. But in the past few years, changing ways of treating Hodgkin's disease have met with increasing success. Radiotherapy is seen to effect a cure in a high proportion of patients when it is given in the early stages of the disease, and can provide good palliation in the later stages also; it is still the only known curative method of treatment; it is the treatment of choice for patients in Stages I, II and III A, and plays an important part in the management of some Stage III B and Stage IV cases. Chemotherapy is of value for symptomatic relief as a preliminary to radiotherapy, for longer-term control in patients with generalised spread of their disease when first seen or in those who develop wide recurrence after initial irradiation, and for obtaining remissions in more advanced cases by combined drug treatments. Results of treatment at the Royal Marsden Hospital of all patients with Hodgkin's disease seen in the period 1935–1966 are reviewed.