Split-course radiotherapy of Hodgkin's disease: local tumor control and normal tissue reactions

One hundred and thirty-six consecutive patients with Stage I-II Hodgkin's disease treated between 1965 and 1969 received a standard tumor dose of 40000 rads to clinically recognized disease using daily fractions of 200 rads given 4 or 5 times per week. Continuous and split-course irradiation, the latter with a 2-2 1/2 week interuption midway through the treatment, were employed in 82 and 54 patients, respectively. "Boost" doses were never given to residual masses at the completion of treatment with either schedule. No loss of therapeutic effectiveness resulted from split-course irradiation, only a single local recurrence having been observed to date. However, patient tolerance with the latter method was substantially better than with continuous irradiation and resulted in fewer subsequent complications. Furthermore, the low incidence of local recurrence fails to support a practice of administering supplementary irradiation to adenopathy which has not completely resolved after a tumor dose of 40000 rads.