Division of Hematology, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Cancer Rep (Hoboken). 2023 Aug;6(8):e1839. doi: 10.1002/cnr2.1839. Epub 2023 May 31.
The survival rate of adult patients with Hodgkin lymphoma (HL) depends on the responses to standard chemotherapy, radiotherapy, or combined therapy. Resource-limited countries face numerous obstacles in supporting patients with HL who undergo chemotherapy, especially in advanced stages.
To analyze the survival outcomes of adult patients with HL after combined-modality treatment (CMT) with involved-field or non-involved-field radiotherapy.
We retrospectively reviewed the medical records of 90 adult patients with HL who received CMT at Rajavithi Hospital, Bangkok between 2007 and 2021. Patients with stage I-IV disease received different therapies depending on their risk group. The risk groups were evaluated according to initial response, bulky disease, and B symptoms. Patients (n = 90) who underwent CMT were followed up for 34.7 months (range, 1-141 months). The median follow-up periods of early and advanced-stage patients were 53.1 months and 23.5 months, respectively. The estimated 5-year overall survival (OS) and progression-free survival (PFS) rates of patients with advanced-stage diseases were 85% and 62%, respectively. There was a difference in the 3-year overall survival among advance-stage patients who underwent ABVD (94%) compared to those administered BEACOPPesc (50%), and the 3-year PFS (84%) among patients who underwent ABVD was higher than that among those administered BEACOPPesc (66%). Radiotherapy increased toxicity but did not improve the survival rate.
Chemotherapy administered to patients with advanced-stage adult HL was more effective than BEACOPPesc when ABVD was administered. Our findings are relevant for hospitals with limited resources.
成人霍奇金淋巴瘤(HL)患者的生存率取决于对标准化疗、放疗或联合治疗的反应。资源有限的国家在支持接受化疗的 HL 患者方面面临着许多障碍,尤其是在晚期阶段。
分析采用累及野或非累及野放疗的联合模式治疗(CMT)后成人 HL 患者的生存结果。
我们回顾性分析了 2007 年至 2021 年期间在曼谷 Rajavithi 医院接受 CMT 的 90 例成人 HL 患者的病历。根据风险组,为 I-IV 期疾病患者提供不同的治疗方案。风险组根据初始反应、肿块病和 B 症状进行评估。接受 CMT 的患者(n=90)接受了 34.7 个月(范围 1-141 个月)的随访。早期和晚期患者的中位随访期分别为 53.1 个月和 23.5 个月。晚期疾病患者的 5 年总生存率(OS)和无进展生存率(PFS)估计分别为 85%和 62%。接受 ABVD 治疗的晚期患者 3 年 OS(94%)与接受 BEACOPPesc 治疗的患者(50%)之间存在差异,接受 ABVD 治疗的患者 3 年 PFS(84%)高于接受 BEACOPPesc 治疗的患者(66%)。放疗增加了毒性,但没有提高生存率。
在 ABVD 给药时,与 BEACOPPesc 相比,晚期成人 HL 患者接受的化疗更有效。我们的发现与资源有限的医院相关。