Ishida Y, Mukai K, Takayama J, Ohira M, Shimoyama M
Rinsho Ketsueki. 1989 Apr;30(4):452-9.
Twenty two cases with Hodgkin's disease under 20 years of age who were diagnosed and treated in National Cancer Center during 1962-1986 were studied retrospectively. The most common initial symptom was swelling of lymph nodes (86%) and only 5 cases (23%) showed "B" symptoms. Laboratory findings showed that there were some cases with increased WBC counts but only 2 cases with an elevated LDH value. In 2 out of 4 cases serum copper value correlated well with their clinical state. Histologically lymphocyte predominance type, mixed cellularity type and nodular sclerosis type almost equally occurred in children younger than age 15 years. On the other hand nodular sclerosis type with mediastinal mass was predominantly encountered in older patients (especially female). The ten years' survival rate in stage I and II patients was 59% compared with 21% in stage III and IV patients. As for the results of initial treatment, complete remission and 10 years' survival rate were 91% and 87% in recent 12 years (1975-1986) compared with 55% and 36% in the preceding 13 years (1962-1974) respectively. Autopsy findings revealed rare involvements of the central nervous system and kidneys. Various late effects which may be caused by escalating doses of radiotherapy occurred in 6 out of 9 cases under the age of 15 years who survived. On the basis of these results lower-doses of radiotherapy combined with systemic chemotherapy appeared to be advisable for the treatment of childhood Hodgkin's disease.
对1962年至1986年期间在国家癌症中心诊断和治疗的22例20岁以下的霍奇金病患者进行了回顾性研究。最常见的初始症状是淋巴结肿大（86%），只有5例（23%）出现“B”症状。实验室检查结果显示，有些病例白细胞计数增加，但只有2例乳酸脱氢酶值升高。4例中有2例血清铜值与临床状态密切相关。组织学上，15岁以下儿童淋巴细胞为主型、混合细胞型和结节硬化型几乎同样常见。另一方面，有纵隔肿块的结节硬化型在老年患者（尤其是女性）中占主导地位。I期和II期患者的十年生存率为59%，而III期和IV期患者为21%。至于初始治疗结果，最近12年（1975 - 1986年）完全缓解率和十年生存率分别为91%和87%，而前13年（1962 - 1974年）分别为55%和36%。尸检结果显示中枢神经系统和肾脏受累罕见。9例存活的15岁以下儿童中有6例出现了因放疗剂量增加可能导致的各种晚期效应。基于这些结果，低剂量放疗联合全身化疗似乎是治疗儿童霍奇金病的可取方法。
