الفهرس 
EpidemiologyOnly 14 pages are availabe for public view
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Abstract
This study inciuded 169 patients, 79 cases of pediatric and 90 cases of adults with advanced stage Hodgkin’s disease (stage 111 and IV) treated at Radiation Oncology Department, NCI, Cairo University during the period between January 1990 to December 1 996. The median age in children was 9.5 years and in adults was 34 years. The male to female ratio waF, 5.6: 1 in pediatric and 3.5 : 1 in adults. According to Ann Arbor staging system, 70 patients had stage 111 and 9 had stage IV in pediatric while in adults 74 patients had stage I11 and 16 patients had stage IV. Unfortunately, 37 patients lost follow rip, , and they were excluded froin treatment results and survival analysis. According to Rye classification, the mixed cellularity and nodular sclerosis were the most frequent pathological subtypes encountered in the present study . The main line of treatment was cheinotlierapy using ABVD, C.MOPP or alternating ABVD & C.MOPP in adults and COPPIOPPA, C .MOPP or E.COP/E. OPA in pediatric. Complete remission was 60.7% in pediatric and 57.7% in adults and after addition of radiotherapy the complete remission rate was raised to 90.2% in pediatric and 90.1 % in adults. These results proved the importance of addition of radiotherapy in treatment of advanced stage HD either as a consolidation or adjuvant treatment on increase treatment response and s~rvivarla te . In children, 56 patients received r-adiotliempy in addition to initial chemotherapy, 89.3% of patients achieved complete response (50/56), while the incidence of relapse in those patients was 18% with median period of 19.4 ~nontl~. Fsi ve patients only who treated by cl~emotherapy achieved complete response, However, all of them developed relapse after a median period of 17.8 months. While in adults, 36 patients received radiotherapy in addition to initial chemotherapy all patients achieved complete response (36/36), while the incidence of relapse in those patients was 41.7% (1 5/36) with median period of 13.9 months. Thirty five patients who treated by chemotl~erapy achieved complete response of (80%), However, the relapse incidence in those patients was (1 00%) with median period of 1 2.1 months . . . Among many different prognostic factors which have been analysed, the prognostic factors with statistical significance were ESR, mediastinal involvement, pathological subtypes and disease Free interval whatever less than one year or more than one year in both adults & children . However, in adults nodal size proved to be statistically significant also. Recommendations: -A national cancer registry is need to find out accurately the profile of malignancy especially among children. -A national protocol for treatment of malignant disease in adults and pediatric is needed . -Aggressive treatment protocols is highly need for cases with bad prognostic signs at presentation. -Further studies with new treatment modalitis to improve the incidence of response and stsvival in patients with Hodgkin’s disease, particularly those with advanced disease stage.