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Background. Beginning in 1970, a series of patients with Hodgkin disease were treated at the University of Minnesota, after staging laparotomy, with radiation therapy (RT) for Stage I, II, and IIIA Hodgkin disease. This report is an analysis of the results of the treatment and of treatment modifications. Methods. From 1970 to 1974, all patients were treated with standard RT. In 1975, an analysis of these patients indicated that patients with large mediastinal mass (LMM) and patients with Stage IIIA spleen-positive (IIIAS+) disease had a higher recurrence rates than patients without these factors. Subsequently, a schema of radical radiation therapy (RRT) was devised, which included low-dose lung RT for patients with LMM and low-dose liver RT for patients with IIIAS+ disease. Results. Analysis of the results of the two treatments indicates that the use of low-dose lung RT in patients with LMM and low-dose liver RT in patients with IIIAS+ Hodgkin disease produced survival and recurrence-free survival results equivalent to those achieved by use of combined modality treatment (CMT) or chemotherapy (CT) alone. Conclusions. The use of RT with whole lung and liver irradiation for patients with LMM and IIIAS+ Hodgkin disease, respectively, produces results that are equivalent to those of CMT or CT alone with the advantage of a decreased incidence of second malignant neoplasms. In addition, patients who do not respond to initial RT have a greater chance of being saved with chemotherapy than do patients initially treated with CMT of being saved with RT. The authors suggest that radical RT is the treatment of choice for patients with LMM and/or IIIAs+ Hodgkin disease. Cancer 1992; 70:693-703.

Renovascular hypertension (increased pressure of the renal artery, supplying the kidney) may be accompanied by uremia (a toxic condition associated with kidney insufficiency). Intractable hypertension may be treated by reconstructive surgery on the kidney vessels, or more recently by percutaneous transluminal renal angioplasty. This less invasive procedure involves introduction of a balloon-tipped catheter into the blocked blood vessel; the balloon is inflated until the inside diameter of the vein is no longer too small. It has been suggested that this procedure is less expensive than the reconstructive procedure, but has a higher rate of complications. An analysis was made of clinical outcome and health care costs of 21 patients who underwent angioplasty and 16 who underwent reconstructive surgery. All patients had renovascular hypertension with or without uremia which was not responding to medication. Either partial or complete success was achieved in 19 of the 21 angioplasty patients. All surgical procedures were successful. Restenosis (repeat narrowing) occurred in six of the angioplasty patients but none of the surgical patients. Average follow-up was 49 months. At this time 69 percent of those in the angioplasty group experienced primary patency (completely open vessels), while it was 100 percent in the operated group. Ninety percent of the angioplasty patients showed improvement in their hypertension, and 81 percent of the operated group. The total average cost of surgery was 12 percent higher than for angioplasty (including the additional cost of treatment for the restenoses). (Consumer Summary produced by Reliance Medical Information, Inc.)