Patients with massive mediastinal Hodgkin's disease are known to have a somewhat poorer response to treatment than other Hodgkin's patients. This trial was designed to improve the response rate and disease-free survival of patients with any stage massive mediastinal Hodgkin's disease. Patients on this study are fully staged and simulated for radiation therapy prior to beginning chemotherapy, which consists of alternating cycles of two non- cross-resistant regimens, MOPP and ABVD for a total of six months of therapy. Patients who are in complete remission following chemotherapy receive radiation therapy delivered in a novel way. The first lOGy are administered to the original extent of disease and an additional 35-4OGy is delivered to any residual mediastinal mass. To date, there are 65 evaluable patients, 55 (85%) achieved a complete response. There have been 10 relapses (18%). Thirteen patients have died, one with a treatment related pneumonitis. These results are the best that have been obtained in this subgroup of patients with Hodgkin's disease.
