Division of Hematology/Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, and the UW Carbone Cancer Center, Madison, WI 53705, USA.
Cancer J. 2012 Sep-Oct;18(5):383-9. doi: 10.1097/PPO.0b013e31826aed6d.
Follicular lymphoma is a diverse disease, both biologically and clinically. Patients may present with symptomatic or asymptomatic disease and with high or low tumor burden. Decisions to treat in the frontline are made based on histology, presence or absence of symptoms, disease burden, comorbidities, patient age, and patient preferences. As most patients with follicular lymphoma will eventually have a relapse, preservation of downstream treatment options also warrants consideration. One must be cognizant of toxicities and how these toxicities may influence later treatments. Given the number of variables, the decision making is often complex, and a certain amount of individualization is required. The goals of this review were to provide a framework for decision making and review the literature supporting the various options.
滤泡性淋巴瘤在生物学和临床方面均具有多样性。患者可能表现为有症状或无症状疾病，以及高肿瘤负荷或低肿瘤负荷。一线治疗的决策基于组织学、症状的存在或不存在、疾病负担、合并症、患者年龄和患者偏好。由于滤泡性淋巴瘤的大多数患者最终都会复发，因此保留下游治疗选择也需要考虑。人们必须认识到毒性以及这些毒性如何影响以后的治疗。鉴于存在许多变量，决策通常很复杂，需要进行一定程度的个体化。本综述的目的是提供决策框架，并回顾支持各种选择的文献。
