Background and Objectives: The optimal treatment of early-stage Hodgkin lymphoma has been controversial because of the success of several approaches. Concerns regarding radiation toxicities and the previously detected good response to chemotherapy have led some to withhold radiation therapy (RT) for the treatment of stage I , II and IIIA Hodgkin's lymphoma. The aim of This study To determine whether combined modality therapy (CMT) is superior to chemotherapy (CT) alone in early stage Hodgkin’s lymphoma patients.Patients and methods: This was a prospective clinical trial carried in Kasr El Aini Oncology And Nuclear Medicine Centre (NEMROCK) . From February 2007 to June 2011, untreated Hodgkin Lymphoma patients with clinical stages (CSs) IA, IB, IIA, IIB, and IIIA were randomized to 4 cycles of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) alone or 4 cycles of ABVD followed by radiation therapy (RT) (3600) cGy. Patients were tested for pre-treatment sCD30 and IL13 levels. Response rate, disease free survival and overall survival were estimated by the Kaplan-Meier method, and Cox multivariable Regression model was used to analyze trends.Results: Of 60 patients randomized 30 receive RT after 4 cycles of ABVD; the complete remission (CR) percentage was 83.3% and partial response, 16.7%. For ABVD alone, 73% achieved a CR; 23.3%, a partial response (PR); and 3.3%, disease progression. At 30 months relapse rate, progression free survival (PFS), and overall survival (OS) for ABVD _ RT versus ABVD alone are 16.7% versus 28.4% , 83% versus 60% (P _ .004), and 93.3% versus 90% (P _ .222), respectively (log-rank).Conclusion: Additional radiotherapy improves response, prevents relapse and increases RFS in patients receiving four cycles of ABVD hemotherapy. Combined modality treatment (ABVD and consolidation radiotherapy) is standard of care. A biological parameter such as serum sCD30 level could be helpful in obtaining a more precise selection of patients suitable for more intensive treatment.