Role of intensive radiotherapy in the management of Hodgkin's disease

Arguments supporting the view that Hodgkin's disease is always incurable are examined critically and rejected in the light of modern advances in diagnostic methodology and the development of techniques for intensive wide-field mega-voltage radiotherapy. Previously untreated patients with Hodgkin's disease deserve an aggressive hopeful approach; a meticulous clinical evaluation, including routine lymphangiography, permits accurate staging, on the basis of which informed decisions regarding treatment may be made. Wide-field mega-voltage radiotherapy to doses of 3,500 to 4,000 rads in 4 weeks is the treatment of choice for regionally localized disease and offers a substantial chance of permanent cure. Intensive radiotherapy also has been tolerated impressively well by patients with generalized (stage III) disease in a clinical investigation currently in progress.