treatment of stage iiia hodgkins disease current treatment for stage iiia hodgkins disease consists of total nodal radiation therapy or a combination of radiation therapy rt and chemotherapy in most series 5065 of stage iii2a patients receiving rt alone have a 5year diseasefree survival dfs when chemotherapy is added to rt the percent of patients having a 5year dfs is increased to 7689 at the university of chicago we have identified prognostic subgroups of patients based on the extent of abdominal disease pathologic substage iii2a patients treated with total nodal rt alone have a significantly lower 5year dfs rate 54 than do iiia patients treated with combinedmodality therapy 100 p 0015 pathologic substage iii1a patients in the two treatment groups show no significant differences in 5year dfs p 069 given the potential for longterm morbidity following combinedmodality therapy we recommend that careful pathologic staging be used to determine which patients would benefit most from rt plus chemotherapy future treatment programs must be designed to minimize chronic morbidity while maintaining or improving cure rates