Hope-Stone H F
Clin Radiol. 1981 Sep;32(5):519-22. doi: 10.1016/s0009-9260(81)80179-1.
This report reviews the experience of the BNLI in managing localised Hodgkin's disease, since the BNLI began in February 1970. The original problem investigated by this study was the evaluation of 'prophylactic' irradiation treating adjacent apparently unaffected regions, as opposed to radiation directed to only the affected regions of the body. Because lower half Hodgkin's disease is uncommon, the study was confined to patients presenting with upper half disease, without 'B' symptoms. Diagnostic laparotomy and splenectomy was not considered to be a mandatory investigation and at the commencement of the study was recommended by only two collaborators. By the completion of the study the majority of collaborators were recommending this procedure routinely. This study therefore includes two additional subgroups of patients with Stages I, IIA (upper half) Hodgkin's disease. In the laparotomised group of patients a 10-year survival rate of almost 95% with either 'local' or 'prophylactic' irradiation suggests that wide field irradiation (including total nodal irradiation) is not essential in the cure of apparently localised Stages I, IIA (upper half) Hodgkin's disease, provided the extent of the disease has been accurately determined by previous investigation. In those patients treated with strictly 'localised' (as opposed to 'prophylactic') irradiation, relapses in adjacent unirradiated regions have been completely controlled by additional treatment, usually irradiation, and none have died of Hodgkin's disease.
本报告回顾了自1970年2月英国国家淋巴瘤研究组（BNLI）成立以来，该组织在治疗局限性霍奇金病方面的经验。本研究最初探讨的问题是评估对相邻看似未受影响的区域进行“预防性”照射，而非仅对身体受影响区域进行放疗。由于下半身霍奇金病并不常见，该研究仅限于上半身患病且无“B”症状的患者。诊断性剖腹术和脾切除术不被视为一项强制性检查，在研究开始时只有两名合作者推荐进行此项检查。到研究结束时，大多数合作者都常规推荐这一操作。因此，本研究还纳入了另外两组患有I期、IIA期（上半身）霍奇金病的患者亚组。在接受剖腹术的患者组中，无论是“局部”照射还是“预防性”照射，10年生存率近95%，这表明对于明显局限性的I期、IIA期（上半身）霍奇金病，只要通过先前的检查准确确定了疾病范围，广泛野照射（包括全淋巴结照射）并非治愈所必需。在那些接受严格“局部”（而非“预防性”）照射的患者中，相邻未照射区域的复发通过额外治疗（通常是照射）已得到完全控制，且无人死于霍奇金病。
