Complications of total nodal irradiation of Hodgkin's disease stages III and IV

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Abstract
Patients (127) with Hodgkin''s disease, Stages III-IV, received total nodal irradiation [TNI]. Of these, 101 patients were managed primarily by radiation therapy employing the split course sequential segmental radiation technique called the 3 and 2. A dose of 3800-4000 rad is delivered in 2 phases in an overall period of 12-13 wk (TDF 61-64; 1094-1148 rets [roentgen equivalent therapy units]). For various reasons the remaining 26 patients received their mantle irradiation to full doses 3800-4000 rad in 4 wk (TDF 63-66; 1112-1184 rets) without rest periods, and a few were irradiated after failing chemotherapy. Of the 101 patients treated between 1969-1974 using the 3 and 2 technique, 2 developed pericarditis (2.0%), none manifested symptomatic pneumonitis (0%), and 3 hypothyroidism (3.0%). The low incidence of severe complications is primarily the result of the technique employed to give TNI. The overall incidence of herpes zoster was 42% (53/127), and there was a slightly higher incidence when TNI was given following splenectomy.

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