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Stage 1A Hodgkins Disease-- Is radiation enough?
Dec 10, 2001

I have recently been diagnosed with Stage 1A Hodgkins Lymphoma as a result of a Biopsy, CT Scan, MRI, Bone Marrow, and PET Scan. I have been undectable for 5 years with a CD4 of 400. My Oncologist is recommending Radiation Therapy without Chemo, since the lymphoma is limited to one lymph node in my neck. My question is, is this a standard approach for treatment of Stage 1A, or is chemo and radiation the standard? Thank you for your valuable insight.

Response from Dr. Dezube

This is not such an easy question as there are several approaches ALL of which are quite good. I am missing one piece of information and that is what type of Hodgkin's disease do you have (there are 4 types, nodular sclerosis, mixed cell, lymphocyte depleted, lymphocyte predominant). In HIV NEGATIVE folks, Stage 1A Hodgkin's disease can be treated by radiation therapy alone, chemotherapy alone (ABVD), or by the combination of the two. We know that radiation therapy alone is adequate for patients who have Stage 1A nodular sclerosing Hodgkin's and who are HIV negative. HOWEVER, we do NOT know if such an approach is suitable for HIV positive patients and I don't know which type of Hodgkin's you have. Since HIV Hodgkin's is more aggressive than HIV negative Hodgkin's, I personally treat all my HIV-Hodgkin's patients with 6 cycles of ABVD chemotherapy. The radiation therapy, which has been recommended to you, may be enough, but it's not what I usually do. I'm sorry if I'm throwing a monkey wrench into the picture at this point. Please keep me posted. BD.

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