Klotzka Aneta, Sobańska Karolina, Iwańczyk Sylwia, Grygier Marek, Woźniak Patrycja, Błaszyk Maciej, Rozwadowska Natalia, Lesiak Maciej
I Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznań, Poland.
Department of Radiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland.
J Clin Med. 2023 Oct 13;12(20):6506. doi: 10.3390/jcm12206506.
Lymphomas are a group of malignant tumors that originate in the lymphatic system. It is the most common type of blood cancer. It affects the lymph nodes, spleen, bone marrow, blood, and other organs. They can be aggressive or chronic. Hodgkin lymphoma survival rate is 2 in 100,000 people. Young adults aged 20-30 and people over 50 are most often affected. The prognosis of Hodgkin's lymphoma is good, with a survival rate of up to 80 percent. Nevertheless, in 20-30 percent of patients who initially respond to treatment, the disease has a tendency to progress. The positive effect of radiotherapy (RT) on patients' survival rates has been proven in many randomized clinical trials. Although the dose of chest RT has significantly reduced over the years, we still struggle with the long-term complications of post-RT repercussions, mainly because there is no established safe dose of RT affecting the heart. Other complications include earlier onset of coronary artery disease, early and late onset of pericarditis, valve degeneration (predominantly of the left heart), calcification of the aorta and its branches, heart failure, and arrhythmias. One patient can manifest each of the abovementioned complications, as in the present case. That is why choosing the right treatment strategy is crucial.
淋巴瘤是起源于淋巴系统的一组恶性肿瘤。它是最常见的血癌类型。它会影响淋巴结、脾脏、骨髓、血液和其他器官。淋巴瘤可分为侵袭性或慢性。霍奇金淋巴瘤的发病率为十万分之二。20至30岁的年轻人和50岁以上的人群最常受到影响。霍奇金淋巴瘤的预后良好,生存率高达80%。然而,在最初对治疗有反应的患者中,有20%至30%的人病情有进展的趋势。放疗(RT)对患者生存率的积极影响已在许多随机临床试验中得到证实。尽管多年来胸部放疗的剂量已大幅降低,但我们仍在为放疗后长期并发症而困扰,主要是因为尚未确定影响心脏的安全放疗剂量。其他并发症包括冠心病的早发、心包炎的早发和迟发、瓣膜退变(主要是左心)、主动脉及其分支的钙化、心力衰竭和心律失常。一名患者可能会出现上述每种并发症,就像本病例一样。这就是为什么选择正确的治疗策略至关重要。