Department of Haematology, University College London Medical School, Cancer Institute, UK.
Lancet. 2012 Sep 1;380(9844):836-47. doi: 10.1016/S0140-6736(12)60035-X. Epub 2012 Jul 25.
Management of Hodgkin's lymphoma continues to develop. Outcomes for patients with favourable-risk, early-stage disease are excellent, and serial reductions in intensity of treatment have been made to retain the excellent prognosis while reducing the late effects of treatment. Prognosis is also very good in advanced-stage disease but the rate of relapse is higher than in early-stage disease, and the optimum first-line treatment is unclear. Workers are investigating the role of functional imaging to assess whether treatment can be tailored according to response, with the most intensive therapies reserved for patients predicted to have poor outcomes. In this Seminar we critically appraise the management of Hodgkin's lymphoma in early-stage disease, advanced-stage disease, and at relapse, with a focus on late effects of treatment.
霍奇金淋巴瘤的治疗仍在不断发展。早期低危患者的治疗效果极佳,治疗强度不断降低,在保留良好预后的同时降低了治疗的远期副作用。晚期患者的预后也很好,但复发率高于早期患者,最佳的一线治疗方案尚不清楚。研究人员正在研究功能成像的作用,以评估是否可以根据治疗反应来调整治疗方案,将最密集的治疗方法保留给预计预后不良的患者。在本次研讨会上,我们将重点关注治疗的远期副作用,对早期疾病、晚期疾病和复发时的霍奇金淋巴瘤的治疗进行批判性评估。