SOR Hodgkins disease

Abstract

The development of extended-field radiotherapy, of chemotherapy and then of the combination of the two therapeutic modalities, has led to cure rates of almost 80% in patients with Hodgkins disease (HD). The aim of management in patients presenting with HD must no longer be cure alone, but cure without sequelae and with the best possible quality of life. Further efforts are necessary to reduce the long-term toxicity of treatment and to improve the prognosis of recurrent disease and that resistant to standard treatment. Numerous questions remain unanswered regarding the heterogeneous histology and phenotypes of the disease and the diversity of the clinical presentations. This document does not apply to patients who develop HD as a consequence of HIV disease. Similarly, the management of patients with nodular lymphocyte-predominant HD (paragranuloma of Poppema), which is considered to be a different entity than HD, is not considered. The SOR document on the management of HD in adults was published in full in 1998. An update is planned for the year 2001. It will deal in particular with: -the best combinations of radiochemotherapy and the move away from radiotherapy as single-modality treatment for stage III supradiaphragmatic disease -the role of international prognostic scores in the development of treatment strategies for disseminated disease -the indications and the best modalities for irradiation in the treatment of advanced disease.