66 P - Twenty years’ experience with hodgkin's disease (HD) at the university of florence: the remaining challenge after a “success story”

Purpose During the last twenty to thirty years remarkable gains in survival of HD patients (pts) have been achieved. The two main goals actually pursued by all the major Centers are a reduction of the toxicity of the treatment for the majority of the pts with better prognosis and the adoption of a more aggressive clinical behaviour in the minority with an “high risk” of relapse and/or death. We therefore reanalyzed the series of the Radiotherapy (RT) and Hematology (HE) Departments of the Florence University (UF). that bave worked togheter in the management of HD in the last two decades, aiming at a better definition of the prognostic value of the different clinicopathologic factors and to evaluate treatment results in the different subsets of pts. Materials and methods From 1960 to 1991. 1531 pts have beeen treated with radical aim. Half of them have been submitted to staging laparotomy with splenectomy. The main features of the series are as follows: Clinical Stage (CS) I. 13%; II, 48%, III. 30%, IV, 9%; General symptoms: A,68%, 8,32%; Histology: LP.12%; NS.43%. MC.40%. LD.5%; Treatment at presentation: RT alone. 52%; Chemotherapy alone, 27%; Combined modality, 21%. Differences in survival rates among the different subsets of patients or according to the treatment given have been analyzed with uni·-and multivariate analysis (Cox model); the same was done for the incidence of the main types of jatrogenic damage. Results Actuarial 10-year disease specific survival for the whole series ranged 86% (CS I pts) to 43% (CS IV pts). A detailed analysis of survival and toxicity results in the different subsets of pts will be presented.