早期霍奇金淋巴瘤的联合化放疗。

Combination chemoradiotherapy in early Hodgkin lymphoma.

机构信息

CHU Dinant Godinne, UCL Namur, 1 Avenue Thérasse, 5530 Yvoir, Belgium.

出版信息

Hematol Oncol Clin North Am. 2014 Feb;28(1):33-47. doi: 10.1016/j.hoc.2013.10.010.

DOI:10.1016/j.hoc.2013.10.010

Abstract

Combination chemoradiotherapy achieves excellent results for the treatment of localized Hodgkin lymphoma. However, late toxic effects occur, mostly related to the radiotherapy administered after the standard adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. The most serious sequelae are radiation-induced secondary cancers. Reducing radiotherapy has not yet prevented late malignancies. However, when radiotherapy was omitted, tumor control was inferior, with more relapses necessitating rescue treatment including high-dose chemotherapy with stem cell support. Early fluorodeoxyglucose positron emission tomography performed after a few cycles of ABVD is evaluated in several randomized trials to identify patients who might be safely treated with chemotherapy alone.

摘要

联合化放疗对于治疗局限性霍奇金淋巴瘤效果极佳。然而，会出现迟发性毒副作用，主要与标准阿霉素、博来霉素、长春花碱和达卡巴嗪（ABVD）化疗后实施的放疗有关。最严重的后遗症是放射性诱导的继发性癌症。减少放疗还未能预防迟发性恶性肿瘤。然而，当省略放疗时，肿瘤控制较差，需要进行挽救治疗，包括大剂量化疗联合干细胞支持。几项随机试验评估了 ABVD 几个疗程后早期进行氟脱氧葡萄糖正电子发射断层扫描，以确定哪些患者可以安全地单独接受化疗。