A re-analysis of available dose-response and time-dose data in Hodgkin's disease

A re-analysis of all available dose-response data on Hodgkin's disease, compiled recently by Vijayakumar and Myrianthopoulos (Vijayakumar, S. and Myrianthopoulos, L.C. An updated dose-response analysis in Hodgkin's disease. Radiother. Oncol. 24: 1-13, 1992), fails to demonstrate any dose-response relationship at doses higher than 32.5 Gy. Thus, in contrast with these authors, we find no evidence that local control will be improved by radiation doses of more than 32.5 Gy. A review of the available data on the time-dose relationship in Hodgkin's disease indicates that overall treatment time, at least up until 7 weeks, is not of major importance. Further, there is some indication that the sensitivity to changes in dose per fraction is low. This allows the fraction size to be selected from considerations of the level of late treatment related morbidity.