Part II: Hodgkin's lymphoma--diagnosis and treatment

The outcome of patients with all stages of Hodgkin's lymphoma has improved dramatically over the past few decades. This is mainly due to the use of risk-adapted therapies using intensive polychemotherapeutic regimens in combination with other modalities. Patients with early favourable or unfavourable (intermediate) stage disease receive two or four cycles of chemotherapy, respectively, followed by involved-field radiotherapy (20-30Gy). Advanced stage Hodgkin's lymphoma is treated more aggressively using six to eight cycles of chemotherapy but the effectiveness of consolidative radiotherapy for patients who show a complete response after chemotherapy alone is still unknown. The main challenge in the near future will be the development of strategies that decrease late morbidity and mortality but retain the same efficacy of current regimens. In this paper we review current diagnostic techniques and management strategies used to treat Hodgkin's lymphoma, and the range of new modalities being used to improve long-term outcome and patient quality of life.