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Hodgkin's Disease Treatment; which treatment do you prefer?
Mar 13, 2002

I am currently undergoing chemotherapy (ABVD) for Stage 2A Hodgkins Disease. (Nodular-Sclerosis) My viral load is stable and my t-cells were at 400 prior to beginning therapy. Which of the following treatment options would you recommend?

1) Six Cycles of Chemo, followed by 20 Radiation therapy treatments

2) Six Cycles of Chemo alone

3) Four Cycles of Chemo followed by 20 Radiation treatments.

At this point I was leaning toward Four Cycles of Chemo followed by Radiation. Thanks for your continued advice, you have been a valuable resource in deciding upon my treatment strategies.

Response from Dr. Dezube

You have Stage 2A Hodgkin's disease. You should do well with any of the three treatments you outline. Your first choice of 6 cycles of chemo plus 20 radiation treatments strikes me as overkill. These treatments are not benign and if you get "too much" therapy, you can end up getting severe side effects. Your options #2 and #3 are both reasonable, i.e. 6 cycles of chemo or 4 cycles of chemo plus 20 radiation treatments. Since you asked me what I personally recommend, I will tell you, but please realize that both #2 and #3 are acceptable. I personally try to give ALL my HIV-Hodgkin's therapy patients SIX cycles of chemotherapy. The 4 cycles chemo plus radiation approach has not been studies in the HIV-infected population. Only if a patient can truly not tolerate all six cycles, then I offer them the 4 cycles chemo plus radiation approach. This latter scenario, in which I use the 4 cycles chemo plus radiation approach, is one I resort to very rarely. Good luck with your Hodgkin's. Again, patients with Stage 2A tend to do well no matter what.


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