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Background&Objective: The proper treatment for early-stage Hodgkin’s disease is controversial. The purpose of this study was to evaluate the therapeutic outcomes of various treatment strategies in supradiaphragmatic clinical early-stage Hodgkin’s disease. Materials&Methods: This retrospective study reviewed the medical records of 105 eligible patients (49 stage I, 59 stage II) who were treated at radiotherapy- oncology departments of Qaem and Omid hospitals in Mashhad (Iran) from April 1995 to April 2000. 26 patients had B symptoms and 5 had large mediastinal mass. Treatment of patients consisted of chemotherapy alone (43 cases), radiotherapy alone (46 cases, 40 mantle and 6 Total nodal irradiation) and combined modality (16 cases). Survival rates were calculated by Kaplan- Meier model. Log-rank test was used to compare the survival profile between groups. Results: The median age of patients was 25 years with a male to female ratio of 1.56: 1. In comparison with radiotherapy only group, Primary chemotherapy and combined modality groups had significantly more cases with unfavorable factors such as B symptoms, Large mediastinal mass, ESR>40 and stage II. For chemotherapy, combined modality and radiotherapy groups the 5-year progression free survival was 72.5%, 82.5% and 56.2% (P<0.05) and the 5-year disease specific survival was 82.9%, 91.6% and 82.5% respectively. Conclusion: Despite having more cases with unfavorable factors, patients who underwent chemotherapy or combined treatment had lower relapse rates compared to radiotherapy only group. However, there was not a significant difference in 5-year disease specific survival rates between these groups.

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Background & Objective: Surgery and /or radiotherapy are major local treatments for esophageal carcinoma. The results of radiotherapy alone have been unsatisfactory. The purpose of this study was to evaluate the treatment outcome of definitive chemoradiotherapy for patients with esophageal SCC.

 

Materials & Methods: This prospective histological descriptive study was done on 190 nonmetastatic esophageal SCC patients which received definitive chemoradiotherapy (55-64 Gy, Cisplatin 80-100 mg/m2 day 1-5FU 750-1000 mg/m2, 24h infusion days 1-4) with curative intent in cancer research center, Mashhad University of Medical Sciences between Jan 2000-Jan 2004. At least one course of chemotherapy was prescribed concurrently with radiotherapy.

 

Results: There were 99 male and 91female patients with the median age of 65 (range, 25-87). The median radiation dose prescribed was 60 Gy (range, 55-64) and median chemotherapy courses was 4 (range, 1-8). With a median follow-up time of 12 months (range, 3-60), one, two and three-year survival rates were 67.8%, 48.7% and 36.3% respectively and median survival was 22 months. Reduction of symptoms was shown in 84% of patients with dysphagia. 109 patients remained disease free with a median follow-up of 14 months (range, 3-60), among which 34 were followed more than 24 months. We found 81 cases (42.6%) with treatment failure during the follow-up (34 locoregional failure, 14 distant metastases, 33 distant metastases accompanied with locoreginal failure).

 

Conclusion: Although definitive chemoradiotherapy can result in long term disease free survival and even cure in a subset of patients with SCC of esophagus, locoregional failure and distant metastasis has remained the main causes of treatment failure.