Comella P, De Rosa V, Frezza P, Bevilacqua A, Scoppa G, Abate G, Comella G, Pergola M, Zarrilli D
Tumori. 1983 Feb 28;69(1):53-8. doi: 10.1177/030089168306900109.
To assess the prognostic significance of mediastinal involvement of Hodgkin's disease, 91 patients with stage I to III disease treated at our Institute were reclassified according to size of mediastinal disease and other clinical and therapeutic characteristics. Complete remission (CR) was achieved in 46 of 67 (81%) patients without mediastinal involvement, and in 16 of 17 (94%) patients with small mediastinal masses, but only in 10 of 17 (59%) patients with large masses (P less than 0.05). Twenty-seven of 32 (84%) patients treated with irradiation alone and 26 of 28 (93%) patients treated with combined modality therapy reached a CR, whereas such a result was obtained only in 19 of 31 (61%) patients who received MOPP chemotherapy alone (P less than 0.01). In particular, none of the patients with large masses had a CR when treated with chemotherapy alone, whereas no differences in response to therapy were found between patients with large vs. small or no masses when irradiation or combined treatments were utilized. Since combined treatment seems to reach a high proportion of CR and to prevent extranodal relapse, further randomized clinical trials are needed to decide its routine utilization in patients with poor prognostic factors such as large mediastinal adenopathies.
为评估霍奇金病纵隔受累的预后意义，对我院治疗的91例Ⅰ至Ⅲ期患者，根据纵隔疾病大小及其他临床和治疗特征进行重新分类。67例无纵隔受累的患者中，46例（81%）达到完全缓解（CR）；17例纵隔小肿块患者中，16例（94%）达到CR；而17例纵隔大肿块患者中，仅10例（59%）达到CR（P<0.05）。单纯放疗的32例患者中，27例（84%）达到CR；综合治疗的28例患者中，26例（93%）达到CR；而单纯接受MOPP化疗的31例患者中，仅19例（61%）达到CR（P<0.01）。特别是，纵隔大肿块患者单纯化疗时无1例达到CR，而采用放疗或综合治疗时，纵隔大肿块患者与纵隔小肿块或无肿块患者的治疗反应无差异。由于综合治疗似乎能使较高比例的患者达到CR并预防结外复发，因此需要进一步进行随机临床试验，以确定其在纵隔大淋巴结等预后不良因素患者中的常规应用。
