Datsenko P V, Panshin G A
Vopr Onkol. 2015;61(1):45-51.
After a median observation time of 4,5 years, 440 patients with Hodgkin's lymphoma stage I-IV to the Ann Arbor classification were treated with radiotherapy (2200 lymph areas) and ABVD (n=204) or BEACOPP (n=117) or CEA/ABVD (lomustine, etoposide, adriamycine, bleomycine, vinblastine and dacarbacine; n=119) regimens in 1995-2012. Correct allocation of groups with "CR or PR ≥80%" and "PR: 0-79%", after first-line chemotherapy, is extremely important for following RT planning. Adaptation of patients with Hodgkin's lymphoma can take place only after successful treatment, the probability of relapse and fear of repeated courses strongly interfere with this process, especially in the first years after its closure. Duration of remission period, especially in young people, is no less important than the criteria for overall survival. It is impossible to build recommendations for treatment for Hodgkin's lymphoma, based only on long-term survival rates. Importance of radiotherapy in reducing the number of relapses is undeniable, so the idea that the development of the role of chemotherapy in the treatment of the ray method Hodgkin's lymphoma gradually becomes secondary is in serious doubt. Our findings suggest the importance of both maintaining a high disease-free survival and reducing long-term complications in designing treatments of Hodgkin's lymphoma.
在中位观察时间为4.5年之后,1995年至2012年期间,对440例根据安阿伯分期为I-IV期的霍奇金淋巴瘤患者进行了放射治疗(2200个淋巴区域),并采用ABVD方案(n = 204)或BEACOPP方案(n = 117)或CEA/ABVD方案(洛莫司汀、依托泊苷、阿霉素、博来霉素、长春花碱和达卡巴嗪;n = 119)进行治疗。一线化疗后,将患者正确分配到“完全缓解或部分缓解≥80%”组和“部分缓解:0-79%”组,对于后续的放疗计划极为重要。霍奇金淋巴瘤患者的适应过程只能在成功治疗后进行,复发的可能性和对重复疗程的恐惧严重干扰了这一过程,尤其是在治疗结束后的头几年。缓解期的长短,特别是在年轻人中,与总生存标准同样重要。仅基于长期生存率来制定霍奇金淋巴瘤的治疗建议是不可能的。放疗在减少复发数量方面的重要性不可否认,因此关于化疗在霍奇金淋巴瘤放疗方法治疗中的作用逐渐变得次要的观点存在严重疑问。我们的研究结果表明,在设计霍奇金淋巴瘤治疗方案时,维持高无病生存率和减少长期并发症都很重要。