Weh H J, Andrieu J M, Bernard J
Dtsch Med Wochenschr. 1978 Nov 17;103(46):1825-9. doi: 10.1055/s-0028-1129350.
Between 1972 and 1975 a total of 20 patients were treated for stage IV Hodgkin's disease with initial lung involvement. All had pathological findings in the mediastinum, and 17 had a nodular-sclerosing type histologically. Four patients were in full remission after six months of multiple chemotherapy. Further chemotherapy or combined chemotherapy and radiotherapy achieved full remission in a total of eight patients, i.e. a six-year survival rate of 40%. The prognosis was poor if lung involvement was still evident after six-month chemotherapy. But if the lung involvement disappears radiologically the authors recommend further treatment, analogous to that in stages II and III, i.e. exploratory laparotomy with splenectomy, plus upper and - if necessary - lower section radiotherapy.
1972年至1975年间,共有20例IV期霍奇金病患者接受了治疗,这些患者最初均有肺部受累。所有患者纵隔均有病理表现,其中17例组织学类型为结节硬化型。4例患者在接受6个月的联合化疗后完全缓解。进一步化疗或联合化疗与放疗使总共8例患者完全缓解,即六年生存率为40%。如果在6个月化疗后肺部受累仍很明显,则预后较差。但如果肺部受累在影像学上消失,作者建议进行进一步治疗,类似于II期和III期的治疗方法,即剖腹探查加脾切除术,再加上上半身放疗,必要时加上下半身放疗。