Mantle field irradiation for stages IA and IIA Hodgkin's disease

Between 1970 and 1975, 73 patients with surgically staged IA and IIA Hodgkin's disease, localized above the diaphragm, were treated with mantle field irradiation only. 24 patients relapsed during the first 5 years after the primary treatment, but 14 of them obtained long-lasting complete remission after retreatment. 23 patients with lymphocyte-depleted histology, more than 3 sites involved or a mediastinal mass of more than 6 cm had a high relapse rate (60%); these patients need treatment additional to the mantle field irradiation. The other 50 patients had an 80% relapse-free survival, 96% complete remission after treatment of the first relapse, and 98% survival after 8 years. We propose that such patients should receive mantle field irradiation only, as the primary treatment.