Crnkovich M J, Leopold K, Hoppe R T, Mauch P M
J Clin Oncol. 1987 Jul;5(7):1041-9. doi: 10.1200/JCO.1987.5.7.1041.
The treatment records of 180 patients with pathological stage (PS) IB to IIB Hodgkin's disease treated at Stanford University Medical Center (SUMC) or the Joint Center for Radiation Therapy (JCRT) were reviewed. Pretreatment characteristics were analyzed to assess their influence on survival and freedom from relapse (FFR). The two most important disease characteristics predictive of relapse were the number and type of B symptoms present and the mediastinal mass ratio (MMR). Patients with both fevers and weight loss had a 7-year survival and FFR of only 57% and 48%, respectively. The poor prognosis in this group was apparent for treatment with either radiation (XRT) alone or combined modality therapy (CMT). Patients with night sweats only had no adverse effect of B symptoms on outcome. Patients with a MMR greater than 1/3 had a 7-year FFR of only 58% after XRT, but 79% after CMT (P = .12). The 7-year survivals for these patients were 85% and 88%, respectively. CMT improved the FFR of the entire group of 180 patients when compared with XRT (7-year FFR 86% and 74%, respectively, P = .02); however, survival in the two treatment groups was similar (88% and 89%). Among patients treated with radiation alone, there was a similar survival and FFR irrespective of whether pelvic irradiation was included in the initial treatment fields.
回顾了在斯坦福大学医学中心（SUMC）或联合放射治疗中心（JCRT）接受治疗的180例病理分期（PS）为IB至IIB期霍奇金病患者的治疗记录。分析治疗前特征以评估其对生存和无复发生存率（FFR）的影响。预测复发的两个最重要的疾病特征是存在的B症状的数量和类型以及纵隔肿块比（MMR）。同时出现发热和体重减轻的患者7年生存率和FFR分别仅为57%和48%。无论单独采用放射治疗（XRT）还是综合治疗（CMT），该组患者的预后都很差。仅出现盗汗的患者，B症状对预后无不良影响。MMR大于1/3的患者在接受XRT后7年FFR仅为58%，但接受CMT后为79%（P = 0.12）。这些患者的7年生存率分别为85%和88%。与XRT相比，CMT提高了180例患者的FFR（7年FFR分别为86%和74%，P = 0.02）；然而，两个治疗组的生存率相似（88%和89%）。在仅接受放射治疗的患者中，无论初始治疗野是否包括盆腔照射，生存率和FFR相似。
