对全淋巴结照射作为ⅢA期霍奇金病治疗方法的评估。

An evaluation of total nodal irradiation as treatment for stage III A Hodgkin's disease.

作者信息

Mauch P, Goodman R, Rosenthal D S, Botnick L, Piro A J, Hellman S

出版信息

Cancer. 1979 Apr;43(4):1255-61. doi: 10.1002/1097-0142(197904)43:4<1255::aid-cncr2820430413>3.0.co;2-v.

DOI:10.1002/1097-0142(197904)43:4<1255::aid-cncr2820430413>3.0.co;2-v

Abstract

Between April 1969 and December 1974, 37 patients with surgically staged III A Hodgkin's disease were treated with total nodal irradiation (TNI). Their probability of relapse-free survival at 7 years is 51% and overall survival 82% with the majority of patients remaining disease free after retreatment with MOPP (10 of 16). In contrast, 21 stage III B patients treated with TNI and MOPP chemotherapy over the same time period have a relapse-free survival of 74% and overall survival of 91%. Because of superior results in treating stage III B patients with combined modality treatment, we fell that a relapse-free survival of 51% may not justify continuation of TNI as the only modality of treatment for patients with stage III A disease, and we have initiated a trial of combined radiation therapy and MOPP chemotherapy in these patients. The most effective treatment of stage III A Hodgkin's disease, however, remains uncertain and depends both on the ultimate risk of combined modality treatment and the success of retreatment following relapse after radiation.

摘要

1969年4月至1974年12月期间，37例经手术分期为ⅢA期的霍奇金病患者接受了全淋巴结照射（TNI）治疗。他们7年无复发生存率为51%，总生存率为82%，大多数患者在接受MOPP再治疗后仍无疾病复发（16例中有10例）。相比之下，同期21例接受TNI和MOPP化疗的ⅢB期患者无复发生存率为74%，总生存率为91%。由于联合治疗在治疗ⅢB期患者方面效果更佳，我们认为51%的无复发生存率可能不足以证明继续将TNI作为ⅢA期疾病患者的唯一治疗方式是合理的，因此我们已在这些患者中开展了放射治疗与MOPP化疗联合治疗的试验。然而，ⅢA期霍奇金病最有效的治疗方法仍不确定，这既取决于联合治疗的最终风险，也取决于放疗后复发再治疗的成功率。