Nogová L, Reineke T, Eich H T, Josting A, Müller-Hermelink H K, Wingbermühle K, Brillant C, Gossmann A, Oertel J, Bollen M V, Müller R-P, Diehl V, Engert A
Clinic I for Internal Medicine, Clinic of Radiotherapy and Department of Radiology of University Hospital Cologne.
Ann Oncol. 2005 Oct;16(10):1683-7. doi: 10.1093/annonc/mdi323. Epub 2005 Aug 10.
Since there are no randomized studies, the treatment of choice for patients with early stage lymphocyte-predominant Hodgkin's lymphoma (LPHL) remains unclear. We thus reviewed all LPHL cases registered in the database of the German Hodgkin Study Group (GHSG) and compared the different treatment approaches, such as extended field (EF), involved field (IF) radiation and combined modality (CM) treatment for LPHL stage IA patients.
One hundred and thirty-one patients with LPHL in clinical stage IA without risk factors were analyzed. Forty-five patients were treated with EF radiotherapy, 45 patients with IF radiation and 41 patients received CM treatment. The median follow-up was 78 months in the EF group, 40 months after CM and 17 months after IF, respectively.
A total of 129 patients achieved complete remission (CR and CRu): 98% after EF radiotherapy, 100% after IF radiation and 95% after CM. With a median follow-up of 43 months there were 5% relapses and only three patients died. Toxicity of treatment was generally mild with most events observed after CM.
In terms of remission induction IF radiotherapy for stage IA LPHL patients is as effective as EF or CM treatment. However, longer follow-up is needed before final conclusion as the optimal therapy.
由于尚无随机研究，早期淋巴细胞为主型霍奇金淋巴瘤（LPHL）患者的首选治疗方法仍不明确。因此，我们回顾了德国霍奇金研究组（GHSG）数据库中登记的所有LPHL病例，并比较了不同的治疗方法，如IA期LPHL患者的扩大野（EF）、受累野（IF）放疗和综合治疗（CM）。
分析了131例无危险因素的临床IA期LPHL患者。45例患者接受EF放疗，45例患者接受IF放疗，41例患者接受CM治疗。EF组的中位随访时间为78个月，CM组为40个月，IF组为17个月。
共有129例患者达到完全缓解（CR和CRu）：EF放疗后为98%，IF放疗后为100%，CM治疗后为95%。中位随访43个月时有5%的复发，仅有3例患者死亡。治疗毒性一般较轻，大多数事件在CM治疗后观察到。
就缓解诱导而言，IA期LPHL患者的IF放疗与EF或CM治疗效果相当。然而，在得出作为最佳治疗方法的最终结论之前，还需要更长时间的随访。
