Evaluation of response

• Evaluate by physical examination and repetition of abnormal investigations at initial staging.

• Often performed after 3-4 courses of chemotherapy to ensure adequate response and to determine total duration of treatment.

• Residual masses sometimes present at completion of therapy, notably in mediastinum: may be residual fibrotic tissue with no viable tumour.

• If residual mass evident on CT, gallium scintigraphy, MRI or PET scan may exclude active disease if negative and obviate need for invasive biopsy.

Cotswolds criteria:

CR: complete resolution of all radiological and laboratory evidence of active HL. CRu: 'uncertain CR', identifies the presence of a residual mass that remains stable or regresses on follow-up.

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