Bates James E, Dhakal Sughosh, Mazloom Ali, Casulo Carla, Constine Louis S
Department of Radiation Oncology, University of Florida, Gainesville, USA.
Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, USA.
Radiother Oncol. 2017 Aug;124(2):325-330. doi: 10.1016/j.radonc.2017.07.016. Epub 2017 Aug 1.
While stage III and IV classical Hodgkin lymphoma (HL) patients are often combined and defined as "advanced stage," there are significant differences in disease distribution and burden between the two stages. This may obscure advantages of radiotherapy (RT) in a combined modality therapy strategy in stage III disease due to the relative lack of benefit in stage IV patients.
We queried the Surveillance, Epidemiology, and End Results (SEER) database, restricting our search to patients with stage III classical HL diagnosed from 2004 to 2012, to examine the difference in overall and cause-specific survival (OS and CSS) between patients who did or did not receive RT.
Patients treated with RT had improved OS and CSS relative to those treated without RT (5-year OS 91.6% with RT compared to 71.4% without RT, HR=0.34, p<0.001) and CSS (5-year OS 95.4% with RT compared to 84.7% without RT, HR=0.32, p<0.001). A benefit in OS and/or CSS was seen in all patient subgroups except for older adults (>64years).
These data support at least a cautionary approach to omitting RT from treatment strategies for patients with advanced stage HL.
虽然III期和IV期经典型霍奇金淋巴瘤（HL）患者常被合并定义为“晚期”，但这两个阶段的疾病分布和负担存在显著差异。由于IV期患者相对缺乏获益，这可能会掩盖放疗（RT）在III期疾病联合治疗策略中的优势。
我们查询了监测、流行病学和最终结果（SEER）数据库，将搜索范围限制在2004年至2012年诊断为III期经典型HL的患者，以研究接受或未接受RT的患者在总生存（OS）和特定病因生存（CSS）方面的差异。
与未接受RT的患者相比，接受RT治疗的患者OS和CSS有所改善（5年OS：接受RT为91.6%，未接受RT为71.4%，HR = 0.34，p < 0.001）以及CSS（5年OS：接受RT为95.4%，未接受RT为84.7%，HR = 0.32，p < 0.001）。除老年患者（>64岁）外，所有患者亚组在OS和/或CSS方面均有获益。
这些数据支持至少谨慎对待在晚期HL患者治疗策略中省略RT的做法。
