Englund Annika, Hopstadius Charlotte, Enblad Gunilla, Gustafsson Göran, Ljungman Gustaf
Department of Women's and Children's Health, Uppsala University , Uppsala , Sweden.
Acta Oncol. 2015 Jan;54(1):41-8. doi: 10.3109/0284186X.2014.948058. Epub 2014 Sep 9.
Hodgkin lymphoma (HL) in children constitutes approximately 30% of all pediatric lymphomas in Sweden. The chance of cure is high, but the frequency of late effects has been considerable. Over recent years, efforts have been made to reduce treatment with maintained survival.
All patients 0-17 years, identified in the Swedish Childhood Cancer Register as diagnosed between 1985 and 2009, were included. The material was analyzed using descriptive statistics and for survival estimates the Kaplan-Meier method was used.
Three hundred and thirty-four patients were identified during this time period. The median age was 14 years. Male sex was over-represented, especially in lower age groups and in nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). In nodular sclerosis and in age group 15-17 years, female sex dominated. Most of the cases presented in stages I or II. B-symptoms were present in 38% of cHL, but only in 7% of NLPHL. The number of patients receiving radiotherapy has been significantly reduced during the period studied. The relapse rate in cHL was 10 ± 2% and in NLPHL 16 ± 7%. The relapse rate was significantly higher in cHL stage IIB compared to other stages in the same therapy group. In cHL 6% died, and in NLPHL 0%. The 5-, 10- and 20-year overall survival estimates in cHL were 96 ± 1%, 95 ± 1% and 90 ± 3%, respectively, with no significant difference when comparing different treatment regimens and time periods. The 5- and 10-year overall survival after relapse in cHL was 81 ± 8% and 75 ± 10%, respectively.
During the period studied there is no indication of a decline in survival despite changes in treatment. Survival rates in Sweden are high, and even after relapse chances of cure are high. We were not able to identify any characteristics specific for the group of patients that did not survive.
在瑞典，儿童霍奇金淋巴瘤（HL）约占所有儿童淋巴瘤的30%。治愈的可能性很高，但远期效应的发生率也相当可观。近年来，人们一直在努力减少治疗并维持生存率。
纳入所有在瑞典儿童癌症登记处登记的、1985年至2009年间确诊的0至17岁患者。使用描述性统计分析该材料，并采用Kaplan-Meier方法进行生存估计。
在此期间共识别出334例患者。中位年龄为14岁。男性比例过高，尤其是在低年龄组以及结节性淋巴细胞为主型霍奇金淋巴瘤（NLPHL）中。在结节硬化型以及15至17岁年龄组中，女性占主导。大多数病例处于I期或II期。38%的经典型霍奇金淋巴瘤（cHL）患者有B症状，但NLPHL患者中只有7%有B症状。在研究期间，接受放疗的患者数量显著减少。cHL的复发率为10±2%，NLPHL的复发率为16±7%。与同一治疗组的其他阶段相比，cHL IIB期的复发率显著更高。cHL患者的死亡率为6%，NLPHL患者的死亡率为0%。cHL的5年、10年和20年总生存率估计分别为96±1%、95±1%和90±3%，比较不同治疗方案和时间段时无显著差异。cHL复发后的5年和10年总生存率分别为81±8%和75±10%。
在研究期间，尽管治疗有所变化，但没有生存下降的迹象。瑞典的生存率很高，即使复发后治愈的机会也很高。我们无法确定未存活患者群体的任何特定特征。
