[Prognostic significance of mediastinal involvement and post-therapeutic radiographic changes in the intrathoracic area in Hodgkin's disease].

The prognostic importance of mediastinal affection and its extent was analyzed in a group of 220 patients with Hodgkin's disease in all clinical stages. The results of the total survival period in mediastinal patients are significantly worse, as compared with patients without primary affection of the mediastinum at all evaluated time intervals: in the 5th year after onset of treatment 79% vs. 95% in the 10th, 15th and 20th year 67% vs 86%, 63% vs. 86% and 56% vs. 86%. The survival of patients without a mediastinal tumour does not change after a 10-year period of follow-up, in case of a tumour mass up to 1/3 of the transverse chest diameter it declines from 81% in the 5th year to 59 and to 49% in the 10th and 15th year. In case of extensive mediastinal affection only 61% survive 5 years and 42% survive after 10 years. The differences in survival without signs of the disease are not statistically significant, obviously due to primary radiochemotherapy with alternation of cytostatic combinations. There are no significant differences in the frequency of posttherapeutic X-ray changes in the mediastinal area after primary X-ray therapy alone and after chemotherapy alone, as compared with combined radio-chemotherapy with the incidence of postirradiation changes in 30% of the patients: the incidence of post-irradiation changes is potentiated by the administration of bleomycin, depending on the dose. For evaluation of posttherapeutic X-ray changes in the area of the chest it is essential to monitor the patients by X-ray check-ups with concurrent functional examination of the lungs.