The role of radiation therapy in patients with Hodgkin's lymphoma.

The outcome of patients with Hodgkin's lymphoma (HL) has improved dramatically because of improvement of both chemotherapy and radiotherapy. The need for radiotherapy in the treatment of patients with HL has changed tremendously. At first, extensive radiation was the only treatment option; then limited irradiation was used in addition to chemotherapy. Whether chemotherapy alone can be sufficient remains to be determined. For patients with early-stage HL with or without risk factors, two to four cycles of relatively mild chemotherapy followed by radiotherapy limited to involved fields (20-30 Gy/10-15 fractions) is widely accepted. For patients with advanced-stage HL, powerful chemotherapy is indicated; when partial remission results, chemotherapy is followed by radiotherapy to residual abnormalities, using only a small margin. In the future, treatment will be tailored to individual patients based on prognostic factors (possibly including biologic markers) and accurate evaluation of response to treatment.