Relapse of Hodgkin disease after extended-field radiotherapy

Thirteen relapses occurred among 51 consecutive surgically staged patients with I, IIA, and IIIA Hodgkin disease who achieved complete remission following extended-field radiotherapy. The median disease-free interval was 14 months, but three disseminated relapses occurred at 36, 36, and 39 months. In 6 of the 13 cases, relapses occurred within treated fields. Relapse frequency was greater with advancing stage, but was not related to histology. In 9 of 12 evaluable cases the patients achieved complete remission with MOPP combination chemotherapy. All responders continue in complete remission a median time of 23 months after completing MOPP. This report emphasizes the need for sustained, close follow-up after radical radiotherapy and the excellent response rate of relapsed patients to MOPP combination chemotherapy.