Treatment of Hodgkin's patients with large mediastinal masses

Extended-field therapeutic irradiation is the treatment of choice for the majority of patients diagnosed as having pathologic stage I or II Hodgkin's disease; however, the use of the standard mantle to treat patients with large mediastinal masses has resulted in lower-than-expected relapse-free survival. The modification in which the split-course, shrinking mantle EFI (extended-field isocentric) technique with computed tomography (CT) treatment planning is used in place of the standard mantle allows Hodgkin's patients with large mediastinal masses to be effectively treated by means of extended-field isocentric irradiation, without the need for whole-lung irradiation or chemotherapy. Our modified split-course shrinking mantle EFI technique for the treatment of large mediastinal masses and results are presented.