Engel I A, Straus D J, Lacher M, Lane J, Smith J
Cancer. 1981 Sep 1;48(5):1245-50. doi: 10.1002/1097-0142(19810901)48:5<1245::aid-cncr2820480532>3.0.co;2-e.
A retrospective study of 25 patients with malignant lymphoma who had osteonecrosis of either the femoral or humeral head(s) was undertaken. The common factor present among all patients was the administration of intermittent steroid-containing combination chemotherapy. Seventeen Hodgkin's disease patients received chemotherapy predominantly consisting of an alkylating agent, vincristine, procarbazine, and moderate amounts of prednisone. The non-Hodgkin's lymphoma patients were on various moderate dosage steroid-containing protocols, except three who received prolonged high-dose steroid-containing chemotherapy regimens. Sixteen of the 17 Hodgkin's disease patients and five of the eight non-Hodgkin's lymphoma patients received radiotherapy to the bones that subsequently developed osteonecrosis. Two of the three non-Hodgkin's lymphoma patients who were not irradiated were treated with high-dose steroid-containing chemotherapy regimens. Symptoms developed in patients 12 months and 32 months after completion of chemotherapy and radiotherapy, respectively. Osteonecrosis was a long-term complication of treatment between 1970 and 1979 and occurred in 1.6% of the Hodgkin's disease and 0.12% of the non-Hodgkin's lymphoma patients treated. The authors conclude that the patients at highest risk for this complication are those who receive both radiotherapy to the affected bone(s) and intermittent steroid-containing multiple drug chemotherapy.
对25例患有股骨头或肱骨头骨坏死的恶性淋巴瘤患者进行了一项回顾性研究。所有患者共有的因素是接受含类固醇的间歇性联合化疗。17例霍奇金病患者接受的化疗主要由烷化剂、长春新碱、丙卡巴肼和适量泼尼松组成。非霍奇金淋巴瘤患者采用各种中等剂量含类固醇方案，除3例接受长期高剂量含类固醇化疗方案的患者外。17例霍奇金病患者中的16例和8例非霍奇金淋巴瘤患者中的5例接受了对随后发生骨坏死的骨骼的放射治疗。3例未接受放疗的非霍奇金淋巴瘤患者中的2例接受了高剂量含类固醇化疗方案治疗。症状分别在化疗和放疗结束后12个月和32个月出现。骨坏死是1970年至1979年期间治疗的长期并发症，在接受治疗的霍奇金病患者中发生率为1.6%，在非霍奇金淋巴瘤患者中发生率为0.12%。作者得出结论，发生这种并发症风险最高的患者是那些接受了对受影响骨骼的放射治疗和含类固醇的间歇性多药化疗的患者。
