Verger E, Easton D, Brada M, Duchesne G, Horwich A
Institute of Cancer Research, Sutton, Surrey.
Clin Radiol. 1988 Jul;39(4):428-31. doi: 10.1016/s0009-9260(88)80294-0.
Between 1970 and 1978, 131 patients with laparotomy-staged, supradiaphragmatic Hodgkin's disease were treated at the Royal Marsden Hospital with mantle radiotherapy, reserving chemotherapy for relapse. Forty-four patients relapsed at a total of 64 sites, the majority of which were infradiaphragmatic. Analysis of the factors predicting relapse showed that bulky mediastinal disease, and three or more sites of involvement at presentation significantly decreased disease-free survival in this group. Age above 60 years, high erythrocyte sedimentation rate (ESR) and adverse histology were of borderline significance. Although the majority (75%) of relapsed patients were salvaged with subsequent chemotherapy, it is suggested that patients with three or more sites of nodal involvement and bulky mediastinal disease would be managed best with initial combined modality therapy.
1970年至1978年间，皇家马斯登医院对131例经剖腹术分期的膈上霍奇金病患者进行了斗篷式放射治疗，将化疗留作复发时使用。44例患者出现复发，共64个部位，其中大多数位于膈下。对预测复发的因素进行分析显示，大块纵隔病变以及初诊时累及三个或更多部位显著降低了该组患者的无病生存率。60岁以上、高红细胞沉降率（ESR）和不良组织学具有临界意义。尽管大多数（75%）复发患者随后通过化疗得到挽救，但建议对有三个或更多淋巴结受累部位及大块纵隔病变的患者，采用初始综合治疗方式效果最佳。
