Josting A, Behringer K, Engert A, Diehl V
Klinik I für Innere Medizin, Universität zu Köln.
Internist (Berl). 2004 Jan;45(1):93-101. doi: 10.1007/s00108-003-1094-2.
High cure rates have been achieved in the treatment for patients with Hodgkin's disease in the past 30 years. Depending on stage at diagnosis and further risk factors up to 95% of patients with Hodgkin's disease can be cured with first-line treatment. Modern therapeutic strategies aim at both reducing therapy-induced late toxicities while maintaining effective tumor control. Patients with early stage Hodgkin's disease are now treated with a short course of chemotherapy for control of occult disease and involved field (IF) irradiation. For patients with early unfavourable stages, effectiveness of treatment shall be optimised by introducing the escalated BEACOPP schedule which has been established in the treatment of advanced stages. Questions to be answered in the treatment of advanced stages concern the optimal number of cycles of an effective chemotherapy regimen and the necessity of additional radiation therapy. The role of erythropoetin and PET-imaging is currently being evaluated in ongoing trials. In the future, new therapeutic approaches with biological agents will be of interest.
在过去30年里,霍奇金淋巴瘤患者的治疗已取得了很高的治愈率。根据诊断时的分期及其他风险因素,高达95%的霍奇金淋巴瘤患者可通过一线治疗治愈。现代治疗策略旨在在维持有效的肿瘤控制的同时减少治疗引起的晚期毒性。早期霍奇金淋巴瘤患者目前接受短疗程化疗以控制隐匿性疾病,并进行累及野(IF)照射。对于早期预后不良的患者,应通过采用在晚期治疗中已确立的强化BEACOPP方案来优化治疗效果。晚期治疗中有待回答的问题涉及有效化疗方案的最佳疗程数以及额外放疗的必要性。目前正在进行的试验中评估促红细胞生成素和PET成像的作用。未来,生物制剂的新治疗方法将备受关注。