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儿童非霍奇金淋巴瘤的晚期效应及一线治疗选择。

Late effects and frontline treatment selection for children with non-Hodgkin lymphoma.

机构信息

Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.

Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.

出版信息

Best Pract Res Clin Haematol. 2023 Mar;36(1):101443. doi: 10.1016/j.beha.2023.101443. Epub 2023 Feb 3.

Abstract

Approximately 1 in 640 adults between 20 and 40 years of age is a survivor of childhood cancer. However, survival has often come at the expense of increased risk of long-term complications, including chronic health conditions and higher mortality rates. Similarly, long-term survivors of childhood non-Hodgkin lymphoma (NHL) experience significant morbidity and mortality related to prior cancer treatments, highlighting the importance of primary and secondary prevention strategies to mitigate late toxicity. As a result, effective treatment regimens for pediatric NHL have evolved to reduce both short- and long-term toxicity through cumulative dose reductions and elimination of radiation. The establishment of effective regimens facilitates shared decision-making opportunities for frontline treatment selection that considers efficacy, acute toxicity, convenience, and late effects of treatments. The current review seeks to merge current frontline treatment regimens with survivorship guidelines to enhance understanding of potential long-term health risks to facilitate best treatment practices.

摘要

约每 640 名 20 至 40 岁的成年人中就有 1 人是儿童癌症的幸存者。然而,生存往往是以增加长期并发症的风险为代价的,包括慢性健康状况和更高的死亡率。同样,儿童非霍奇金淋巴瘤 (NHL) 的长期幸存者也经历着与先前癌症治疗相关的显著发病率和死亡率,突出了初级和二级预防策略的重要性,以减轻晚期毒性。因此,为了降低短期和长期毒性,儿科 NHL 的有效治疗方案已经发展到通过累积剂量减少和消除放疗来实现。有效的方案的建立为一线治疗选择提供了共同决策的机会,同时考虑了治疗的疗效、急性毒性、便利性和后期效果。本综述旨在将当前的一线治疗方案与生存指南相结合,以增强对潜在长期健康风险的理解,从而促进最佳治疗实践。

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