Jacquillat C L, Weil M, Auclerc G, Delbrück H, Chastang C L, Chelloul N, Boiron M, Bernard J
Dtsch Med Wochenschr. 1975 Apr 11;100(15):785-90. doi: 10.1055/s-0028-1106296.
204 patients with Hodgkin's disease not previously treated were given vincristine, chlormethine, procarbazine and prednisone (protocol H2-65) for six months, followed by monthly vinblastine injections. Additional prophylactic radiotherapy was given to 50 non-randomised patients. Three-monthly reinduction treatment was administered to a further 50 patients during the year following the original induction cure, afterwards only every six months, and no treatment after four years. Among 109 patients in stage III complete remission occurred in 53% and partial (incomplete) remission in 36%. Among the 58 patients in stage IV, 21 had complete and one incomplete remission. Among 37 patients in stages I and II, 33 went into remission. The remission curves reached a plateau in the 42nd month in 74 plus or minus 6% of those in complete and 56 plus or minus 8% of those in incomplete remission (P less than 0.03). Increasing age had an unfavourable prognosis: the more progressed the anatomical stage the less favourable the prognosis. Surprisingly, stage IV (lymphocyte-poor) had a better prognosis on polychemotherapy than other histological forms. Signs of clinical activity did not influence prognosis, but biochemical signs of activity are unfavourable for remission duration (P less than 0.01). Patients who also had radiotherapy had longer remissions (P less than 0.01). Exacerbations occurred in 38, never beyond the 42nd month. Recurrence occurred in 21 of them in the dame lymphatic region as was affected at the beginning of the disease, while in the other 17 patients an extralymphatic episode occurred. There was a positive correlation between histological form and type of recurrence.
204例未经治疗的霍奇金病患者接受长春新碱、氮芥、丙卡巴肼和泼尼松治疗(方案H2 - 65),为期6个月,随后每月注射长春碱。另外50例非随机分组的患者接受了预防性放疗。在最初诱导治愈后的一年内,对另外50例患者进行每三个月一次的再诱导治疗,之后仅每六个月进行一次,四年后不再治疗。在109例Ⅲ期患者中,53%达到完全缓解,36%为部分(不完全)缓解。在58例Ⅳ期患者中,21例完全缓解,1例不完全缓解。在37例Ⅰ期和Ⅱ期患者中,33例进入缓解期。完全缓解患者的缓解曲线在第42个月达到平台期的比例为74±6%,不完全缓解患者为56±8%(P<0.03)。年龄增加预后不良:解剖分期越晚预后越差。令人惊讶的是,Ⅳ期(淋巴细胞减少型)在多药化疗下的预后比其他组织学类型更好。临床活动体征不影响预后,但生化活动体征对缓解持续时间不利(P<0.01)。接受放疗的患者缓解期更长(P<0.01)。38例出现病情加重,均未超过第42个月。其中21例在疾病开始时受累的同一淋巴区域复发,而另外17例患者出现淋巴外复发。组织学类型与复发类型之间存在正相关。