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- W3147318429 abstract "Controversy isanintegral part of nearlyall major progress inscience and medicine. One exception isthe development of anactive therapy where no previous therapy was effective. A fieldgenerally has no problem adopting a novel active treatment.However, when newer approaches are found that are either saferor more effective or both,they sometimes have trouble displac-ing an established approach.And so it iswith theroleof radia-tion therapy inthe treatment of Hodgkin’s disease.Historically, radiation therapy was the first curative therapyfor Hodgkin’s disease. Technicalinnovations inradiation equip-ment and clever designs of radiation fields broughtustothepoint where patients without B symptoms and withdisease lo-calized to one sideof the diaphragm could have theHodgkin’sdisease permanently eradicated in 80%–85% of cases. Patientswith B symptoms and with more advanceddisease fared con-siderably worse.In the 1960s and 1970s, genuine advances were made incombination chemotherapy programs that were first tested andconfirmed to be active inthe group of patients who could not beoptimally treatedbyradiation therapy, namelythose withBsymptoms and advanceddisease. Theefficacy of chemotherapyinadvanced-stage disease was comparabletotheefficacy ofradiation therapy in early-stage disease such that bythe 1980s,stage was no longer a prognostic factor. Subsequently, theche-motherapy programs were testedin patients usually treated withradiation therapy and were found to beatleast as effective asradiation therapy at eliminating theHodgkin’s disease.As patients began to survive longer after the successful treat-ment of theirHodgkin’s disease, other problems occurredinthese treated patients at a greater frequency than one wouldexpect in an age-matched population that had not been treatedfor Hodgkin’s disease. Fortunately, substantial numbers oflong-term survivors were producedbyradiation therapy andby com-bination chemotherapy, so it was possible to ascertainwhichproblems were related to theunderlying disease and which wererelated to treatment. For example, an increased risk of B-celllymphoma, often involving the gastrointestinal tract, was notedin patients treated with radiation therapy, chemotherapy, or both" @default.
- W3147318429 created "2021-04-13" @default.
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- W3147318429 date "2003-07-02" @default.
- W3147318429 modified "2023-09-27" @default.
- W3147318429 title "Radiation Therapy in the Treatment of Hodgkin's Disease--Do You See What I See?" @default.
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- W3147318429 doi "https://doi.org/10.1093/jnci/95.13.928" @default.
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