Austin-Seymour M M, Hoppe R T, Cox R S, Rosenberg S A, Kaplan H S
Ann Intern Med. 1984 Jan;100(1):13-8. doi: 10.7326/0003-4819-100-1-13.
Fifty-two patients 60 to 75 years of age were treated for Hodgkin's disease at Stanford University between 1968 and 1980. Adequate staging was defined as including a lymphogram and staging laparotomy for stage I to III and a positive bone marrow or liver biopsy or other evidence of diffuse involvement of extralymphatic tissues for stage IV. Adequate treatment was defined as subtotal lymphoid irradiation for pathologic stages I to IIA; total lymphoid irradiation for stages IIB to IIIA; and chemotherapy with or without irradiation for stages IIIB to IV. Twenty-four patients (46%) had advanced disease (IIIB to IV). Those patients who received appropriate treatment had a median survival of only 39 months. Of the 28 patients with limited disease (I to IIIA), 15 had laparotomy and adequate treatment. Thirteen did not have a laparotomy and 7 were treated with involved-field irradiation. The 5-year survival rate in the laparotomy-staged and adequately treated group was 86%, but in the clinically staged group, only 35% (p = 0.006).
1968年至1980年间，斯坦福大学对52名年龄在60至75岁之间的霍奇金病患者进行了治疗。充分分期定义为：I至III期包括淋巴管造影和分期剖腹探查术，IV期包括阳性骨髓或肝脏活检或其他淋巴外组织弥漫性受累的证据。充分治疗定义为：病理I至IIA期进行次全淋巴照射；IIB至IIIA期进行全淋巴照射；IIIB至IV期进行化疗加或不加照射。24名患者（46%）患有晚期疾病（IIIB至IV期）。接受适当治疗的患者中位生存期仅为39个月。在28名疾病局限（I至IIIA期）的患者中，15名进行了剖腹探查术并接受了充分治疗。13名未进行剖腹探查术，7名接受了受累野照射。剖腹探查分期并充分治疗组的5年生存率为86%，而临床分期组仅为35%（p = 0.006）。
