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[非霍奇金淋巴瘤:分类、分期与治疗]

[Non-Hodgkin lymphomas: classification, staging and therapy].

作者信息

Obrecht J P

出版信息

Schweiz Med Wochenschr. 1979 Mar 17;109(11):403-9.

PMID:424710
Abstract

In recent years considerable advances have been made in the treatment of non-Hodgkin lymphomas, yet the results are not so impressive as the progress in treating patients with Hodgkin's disease. This may be partly explained by the lack of standardized histological classification and staging procedures, which are responsible for our incomplete knowledge of the pathogenesis and clinical course of the different lymphoma types. The most important histological classifications and procedures for adequate staging are presented. To the extent of present knowledge the initial manifestations and pathways of dissemination are discussed. So far established data makes it possible to lay down therapeutic principles which differ according to stage and histology. Loco-regional stages should be treated by radiotherapy alone. In advanced phases combined cytotoxic chemotherapy is for the most part the accepted form of treatment. While in prognostically favorable histological types a mild regimen may suffice, aggressive cytotoxic regimens should be preferred in treating unfavorable histological types. Treatment modalities combining radiotherapy and chemotherapy are still experimental. Hodgkin's lymphomas and diffuse histiocytic lymphomas in stages III and IV are potentially curable by chemotherapy.

摘要

近年来,非霍奇金淋巴瘤的治疗取得了显著进展,但结果并不像霍奇金病患者的治疗进展那样令人印象深刻。部分原因可能是缺乏标准化的组织学分类和分期程序,这导致我们对不同淋巴瘤类型的发病机制和临床过程了解不完整。本文介绍了最重要的组织学分类和充分分期的程序。就目前的知识范围,讨论了初始表现和传播途径。目前已确立的数据使得制定根据分期和组织学不同而有所差异的治疗原则成为可能。局部区域分期应仅采用放射治疗。在晚期,联合细胞毒性化疗在很大程度上是公认的治疗方式。虽然在预后良好的组织学类型中,温和的方案可能就足够了,但在治疗预后不良的组织学类型时,应首选积极的细胞毒性方案。放疗和化疗相结合的治疗方式仍处于实验阶段。Ⅲ期和Ⅳ期的霍奇金淋巴瘤和弥漫性组织细胞淋巴瘤有可能通过化疗治愈。

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