RESUMO
BACKGROUND: Bulky mediastinal involvement in Hodgkin disease (HD) is usually considered an adverse prognostic factor. Patients treated with radiotherapy alone (RT) or chemotherapy alone (CT) have a high relapse rate. The combined chemotherapy plus radiotherapy is the therapy of choice. The objective of the present study was to report our results and complications in the treatment of 28 patients with HD with bulky mediastinal involvement. MATERIALS AND METHODS: A retrospective analysis was made of a series of 28 patients with bulky mediastinal disease treated in our hospital from 1973-1993, with RT, CT or combined therapy. The overall survival rate and free of disease, the presence of residual mass, as well as therapy toxicity were studied. RESULTS: The overall remission rate was 85.7%. The overall survival rates and free of disease were 76% and 78% at 19 years. Five patients died due to progression of disease, and one due to pulmonary toxicity. Neither heart disease nor secondary neoplasms were documented. CONCLUSION: Our results, in agreement with those reported in literature, support the combined therapy, chemotherapy plus radiotherapy, as the therapy of choice for patients with HD and bulky mediastinal involvement.
