Follows Annabel M, Santarsieri Anna
University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0SP, UK.
Department of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
Cancers (Basel). 2022 Nov 1;14(21):5390. doi: 10.3390/cancers14215390.
Striking advances in the treatment of Hodgkin lymphoma over the last 30 years have culminated in high rates of disease-free survival in younger patients with early and advanced stage disease. In this review we focus on strategies that have evolved over recent years to reduce short and long-term toxicities of treatment. These strategies include the selection of first-line chemotherapy, the stratification of patients based on initial response and subsequent adaptation of treatment, the addition of novel agents (e.g., brentuximab vedotin), the removal of specific drugs (e.g., bleomycin), the use of drug substitution, and the removal of consolidation radiotherapy based on interim and end of treatment PET assessment. While these strategies have successfully reduced toxicity of Hodgkin lymphoma therapy, the cornerstone of treatment continues to be combination chemotherapy and radiotherapy with significant short- and long-term side effects. To further reduce toxicity while maintaining or improving efficacy, we shall need to incorporate novel agents into our first-line treatment algorithms, and several such potentially practice-changing trials are underway.
在过去30年里，霍奇金淋巴瘤的治疗取得了显著进展，使得早期和晚期疾病的年轻患者无病生存率很高。在这篇综述中，我们关注近年来为降低治疗的短期和长期毒性而发展起来的策略。这些策略包括一线化疗的选择、根据初始反应对患者进行分层以及随后调整治疗方案、添加新型药物（如本妥昔单抗）、去除特定药物（如博来霉素）、使用药物替代以及根据治疗中期和末期的PET评估去除巩固放疗。虽然这些策略已成功降低了霍奇金淋巴瘤治疗的毒性，但治疗的基石仍然是联合化疗和放疗，它们具有显著的短期和长期副作用。为了在保持或提高疗效的同时进一步降低毒性，我们需要将新型药物纳入一线治疗方案中，目前有几项可能改变治疗实践的试验正在进行。
