Gasparini M, Lombardi F, Bellani F F, Gianni C, Pilotti S, Rilke F
Cancer. 1981 Oct 1;48(7):1508-12. doi: 10.1002/1097-0142(19811001)48:7<1508::aid-cncr2820480704>3.0.co;2-f.
Twenty-nine consecutive children with untreated non-Hodgkin's malignant lymphoma were admitted to Istituto Nazionale Tumori of Milan during the period from 1974 through 1976 and underwent treatment with chemotherapeutic regimens consisting of Adriamycin, Cytoxan, vincristine, and prednisone (two month induction phase) and 6-mercaptopurine, methotrexate, Adriamycin, vincristine, and prednisone (maintenance phase). Each patient, regardless of clinical stage of histologic subgroup, was given the same chemotherapy. The complete response rate was 66%. Due to the high incidence of recurrence of the initial bulky lymphomatous mass and of spread to the central nervous system (CNS), local radiotherapy was given to ten children and CNS prophylaxis (brain radiotherapy + intrathecal methotrexate) to 11 children. After a follow-up period in excess of 40 months, there were five disease-free survivors (17%). Each patient who had a relapse died from the disease. The main reason for first treatment failure was relapse at the level of the primary bulky tumor site or spread to the CNS. This type of CNS prophylaxis did not prevent relapse at this site.
1974年至1976年期间，29例未经治疗的非霍奇金恶性淋巴瘤患儿被收治入米兰国家肿瘤研究所，并接受了由阿霉素、环磷酰胺、长春新碱和泼尼松组成的化疗方案（两个月诱导期）以及6-巯基嘌呤、甲氨蝶呤、阿霉素、长春新碱和泼尼松（维持期）治疗。每位患者，无论组织学亚组的临床分期如何，均接受相同的化疗。完全缓解率为66%。由于初始巨大淋巴瘤肿块复发及扩散至中枢神经系统（CNS）的发生率较高，10名儿童接受了局部放疗，11名儿童接受了CNS预防（脑部放疗+鞘内注射甲氨蝶呤）。经过超过40个月的随访期，有5名无病生存者（17%）。每例复发患者均死于该疾病。首次治疗失败的主要原因是原发性巨大肿瘤部位复发或扩散至CNS。这种类型的CNS预防未能防止该部位复发。
