The disease is classified as favorable if there are no large masses.
Standard Treatment Traditionally, patients have exploratory abdominal surgery (a staging laparotomy) to evaluate the spleen , liver and abdominal lymph nodes . This might be avoided when there is little likelihood of disease below the diaphragm, as is the case with disease that appears only in the chest (no lymph nodes), with high neck disease of the nodular sclerosis or lymphocyte predominant sub-types and with young women with Stage I disease. Fewer laparotomies are being performed because of the ability to better predict occult subdiaphragmatic disease and acceptance of a slightly higher risk of relapse.
The standard treatment is radiation to the chest, the lymph nodes in the neck and underarm, and the deep abdominal lymph nodes.
Investigational alternatives include involved field radiation plus mild chemotherapy and combination chemotherapy such as ABVD (Adriamycin + bleomycin + vinblastine + dacarbazine [DTIC]), VBM (velban + bleomycin + methotrexate), and NOVP (Novantrone + Oncovin + vinblastine + prednisone).
