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[霍奇金病肝脏和肺部预防性照射的扩大根治性放疗方案的经验与展望]

[Experience with and perspectives of an extended radical regimen of radiotherapy for Hodgkin's disease with prophylactic irradiation of the liver and the lungs].

作者信息

Pan'shin G A, Kharchenko V P, Sotnikov V M, Datsenko P V, D'iachkova L V, Nechesniuk A V, Tolchinskiĭ B I

机构信息

Russian Center for Roentgenology Research, Ministry of Health of the RF, Moscow.

出版信息

Vopr Onkol. 2000;46(6):718-23.

Abstract

The end-results of extended radical radiotherapy for stage II-III Hodgkin's disease with apparent factors of risk of relapse in the lung and/or liver are presented. The procedure included prophylactic irradiation of both organs. Ten-year relapse-free survival in the lung-irradiation group was 85.9%, overall 10-year survival--94.0%; the liver-irradiation group--90.0 and 94.7%, respectively. Preventive irradiation was shown to significantly decrease the influence of such risks as extended lesions of the mediastinum and spleen. Relapse in the lung was recorded in one case (1.6%) only, with no tumor progression defected in the liver. Significant increase in 5- and 10-year relapse-free survival was established in the lung-irradiation group, as a result of a comparison of the study group and that of controls who showed characteristic signs of intrathoracic risk. Significant difference in overall survival was recorded for the first three years only. As far as the liver-irradiation factor is concerned, the rise in both categories of survival was significant for the 10 years. It is suggested that patients with stage II-III Hodgkin's disease receive prophylactic irradiation whenever they reveal significant signs of risk of relapse in the lung and/or liver.

摘要

本文介绍了对伴有明显肺和/或肝复发风险因素的II - III期霍奇金病进行扩大根治性放疗的最终结果。该治疗程序包括对这两个器官进行预防性照射。肺照射组的10年无复发生存率为85.9%,总体10年生存率为94.0%;肝照射组分别为90.0%和94.7%。预防性照射被证明可显著降低诸如纵隔和脾脏广泛病变等风险的影响。仅1例(1.6%)出现肺部复发,肝脏未发现肿瘤进展。通过将研究组与显示胸内风险特征迹象的对照组进行比较,肺照射组的5年和10年无复发生存率显著提高。仅在头三年记录到总体生存率有显著差异。就肝照射因素而言,两类生存率在10年时均显著上升。建议II - III期霍奇金病患者只要出现肺和/或肝复发的明显风险迹象,就应接受预防性照射。

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