Allen Pamela B, Gordon Leo I
Robert H. Lurie Comprehensive Cancer Center and Division of Hematology and Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Department of Hematology and Medical Oncology, Emory University Winship Cancer Institute, Atlanta, GA, USA.
Clin Med Insights Oncol. 2017 Sep 26;11:1179554917731072. doi: 10.1177/1179554917731072. eCollection 2017.
Hodgkin lymphoma is a highly curable malignancy in early and advanced stages. Most patients are diagnosed in their teens or twenties and are expected to live decades beyond their treatment. Therefore, the toxicity of treatment must be balanced with the goal of cure. Thus, treatment has been refined through prognostic models and positron emission tomography-computed tomography (PET-CT)-directed therapy. Stratification by prognostic models defines groups of patients with favorable characteristics who may be treated with less intensive therapy upfront, including fewer cycles of chemotherapy, lower doses of radiation, or omission of radiation altogether. Alternatively, high-risk patients may be assigned to a more aggressive initial approach. The modern use of interim PET-CT allows further tailoring of treatment by response.
霍奇金淋巴瘤在早期和晚期都是一种高度可治愈的恶性肿瘤。大多数患者在十几岁或二十几岁时被诊断出来，预计在接受治疗后能活几十年。因此，治疗的毒性必须与治愈目标相平衡。于是，通过预后模型和正电子发射断层扫描-计算机断层扫描（PET-CT）引导的治疗，治疗方法得到了改进。通过预后模型进行分层，可以确定具有良好特征的患者群体，这些患者可能一开始接受强度较低的治疗，包括更少周期的化疗、更低剂量的放疗或完全省略放疗。或者，高危患者可能会被采用更积极的初始治疗方法。现代使用的中期PET-CT能够根据反应进一步调整治疗方案。
