Hagemeister F B, Fuller L M, Sullivan J A, North L, Velasquez W, Conrad F G, McLaughlin P, Butler J J, Shullenberger C C
Radiology. 1981 Dec;141(3):783-9. doi: 10.1148/radiology.141.3.6895415.
Three treatment programs for Stage I and II mediastinal Hodgkin disease (established by laparotomy) were compared. Involved-field radiotherapy + MOPP gave a disease-free survival rate of 97%, significantly different from 62% and 55% for involved and extended fields, respectively. Corresponding survival figures of 97%, 88%, and 84% were not significantly different statistically due to salvage with radiotherapy and/or chemotherapy. Among patients given radiotherapy alone, the survival figure of 94% for limited mediastinal disease was significantly better than 63% for extensive mediastinal and hilar disease; corresponding disease-free figures of 72% and 35% were also significantly different. Constitutional symptoms were an important prognostic factor in disease-free survival following the use of involved fields; hilar disease was important only with large mediastinal masses. Most relapses were intrathoracic; MOPP alone salvaged only 47%. Treatment of Stage I and II Hodgkin disease should be based on symptoms, extent of mediastinal disease, and hilar involvement.
对三种针对Ⅰ期和Ⅱ期纵隔霍奇金病（通过剖腹手术确诊）的治疗方案进行了比较。受累野放疗+MOPP方案的无病生存率为97%，与受累野和扩大野放疗方案分别为62%和55%相比，差异显著。由于采用放疗和/或化疗进行挽救治疗，相应的生存率97%、88%和84%在统计学上无显著差异。在仅接受放疗的患者中，局限性纵隔疾病的生存率94%显著高于广泛性纵隔和肺门疾病的63%；相应的无病生存率72%和35%也有显著差异。全身症状是采用受累野放疗后无病生存的重要预后因素；仅在纵隔肿块较大时，肺门疾病才具有重要意义。大多数复发发生在胸腔内；单纯MOPP方案仅挽救了47%的患者。Ⅰ期和Ⅱ期霍奇金病的治疗应基于症状、纵隔疾病范围和肺门受累情况。
