Tan Wen-Yong, Hu De-Sheng, Zeng Fan-Yu, Song Qi-Bin, Hu Sheng, Wei Lai, Zhou Li-Qiang
Department of Radiotherapy, Hubei Provincial Tumor Hospital, Wuhan, Hubei, 430079, PR China.
Ai Zheng. 2007 Dec;26(12):1360-4.
BACKGROUND & OBJECTIVE: The treatment strategies of Hodgkin's lymphoma (HL) are different according to clinical stage and risk factors, yet the optimal treatment strategy remains unclear. This study was to analyze the treatment results and prognostic factors of stage IA HL.
According to prognosis, 97 patients with stage IA HL were divided into 3 groups: 7 (7.2%) in very favorable (VF) group, 72 (74.2%) in favorable (F) group, and 18 (18.6%) in unfavorable (UF) group. Short-term treatment outcome and long-term survival were analyzed. The prognosis was analyzed with Cox regression model.
Median follow-up time was 65 months. After radiotherapy or radiochemotherapy, 90 patients (92.8%) achieved complete remission (CR). The 5-and 10-year overall survival (OS) rates were 87.7% and 76.3%; the 5-and 10-year disease-free survival (DFS) rates were 79.4% and 74.5%. The 5-and 10-year OS rates were 100% and 100% in VF group, 88.9% and 88.4% in F group, 78.1% and 39.1% in UF group (P=0.292). The 5-and 10-year DFS rates were 100% and 87.2% in VF group, 86.3% and 71.8% in F group, 73.6% and 34.5% in UF group (P=0.032). Cox analysis showed that pathologic type (P=0.056) and tumor relapse (P=0.011) influenced OS, and the response to primary treatment (P=0.024) influenced DFS. The relapse rate was 18.6%û there was no significant difference between the patients received radiotherapy alone and those received radiochemotherapy (Chi(2)=0.072, P=0.788). The occurrence rate of secondary malignancies was 5.2%, including 2 cases of non-Hodgkin's lymphoma. All the 12 patients who died had received radiotherapy alone.
More than 90% of stage IA HL patients can achieve CR with radiotherapy alone or chemoradiotherapy. The long-term OS and DFS of the patients who received radiochemotherapy are better than those of the patients who received radiotherapy alone. The pathologic type, response to primary treatment and tumor relapse may be independent prognostic factors of stage IA HL.
霍奇金淋巴瘤（HL）的治疗策略因临床分期和危险因素而异，但最佳治疗策略仍不明确。本研究旨在分析IA期HL的治疗结果及预后因素。
根据预后情况，将97例IA期HL患者分为3组：非常有利（VF）组7例（7.2%），有利（F）组72例（74.2%），不利（UF）组18例（18.6%）。分析短期治疗结果和长期生存情况。采用Cox回归模型分析预后。
中位随访时间为65个月。放疗或放化疗后，90例患者（92.8%）达到完全缓解（CR）。5年和10年总生存率（OS）分别为87.7%和76.3%；5年和10年无病生存率（DFS）分别为79.4%和74.5%。VF组5年和10年OS率分别为100%和100%，F组为88.9%和88.4%，UF组为78.1%和39.1%（P = 0.292）。VF组5年和10年DFS率分别为100%和87.2%，F组为86.3%和71.8%，UF组为73.6%和34.5%（P = 0.032）。Cox分析显示，病理类型（P = 0.056）和肿瘤复发（P = 0.011）影响OS，对初始治疗的反应（P = 0.024）影响DFS。复发率为18.6%，单纯放疗患者与放化疗患者之间无显著差异（χ² = 0.072，P = 0.788）。继发恶性肿瘤发生率为5.2%，包括2例非霍奇金淋巴瘤。所有12例死亡患者均接受了单纯放疗。
超过90%的IA期HL患者单纯放疗或放化疗可实现CR。接受放化疗患者的长期OS和DFS优于单纯放疗患者。病理类型、对初始治疗的反应和肿瘤复发可能是IA期HL的独立预后因素。
