Maurizi Enrici R, Falchetto Osti M, Anselmo A P, Tombolini V, Cartoni C, Scattoni Padovan F, Sbarbati S, Cavaceppi P, Biagini C
Istituto di Radiologia, Università degli Studi La Sapienza, Roma.
Radiol Med. 1995 Jun;89(6):855-60.
January, 1972, through December, 1982, ninety-four patients with Hodgkin's disease in stages I and IIA were treated in the Dept. of Radiation Oncology of the University "La Sapienza", Rome. All patients had a minimum follow-up of 10 years. After careful clinical and surgical examinations comprehensive of laparosplenectomy, all patients were submitted to extended field radiation treatment. Ninety-one of 94 patients (97%) obtained complete remission. Overall survival at 10 years was 91% and independent of stage (94% in stage I and 87% in stage II), while relapse-free survival at 10 years did depend on stage (83% in stage I and 49% in stage II); the difference was statistically significant (p < 0.01). Thirty-one of 94 patients relapsed, but fortunately 94% of them obtained a second complete remission after salvage chemotherapy. Our experience confirms the low tumorigenic potential of exclusive radiation therapy; only one of 4 secondary neoplasms (acute non-lymphatic leukemia) observed in this series had been treated with radiotherapy. The results of this study confirm the efficacy of exclusive irradiation in stage I patients, while treatment approach remains debated in stage II patients. The combination of short-time chemotherapy with curative irradiation is probably the best option to reduce both the incidence of recurrences and treatment-induced complications.
1972年1月至1982年12月期间,罗马“萨皮恩扎大学”放射肿瘤学系对94例I期和IIA期霍奇金病患者进行了治疗。所有患者的最短随访时间为10年。在进行包括腹腔镜脾切除术在内的仔细临床和外科检查后,所有患者均接受扩大野放射治疗。94例患者中有91例(97%)获得完全缓解。10年总生存率为91%,且与分期无关(I期为94%,II期为87%),而10年无复发生存率确实取决于分期(I期为83%,II期为49%);差异具有统计学意义(p < 0.01)。94例患者中有31例复发,但幸运的是,其中94%的患者在挽救性化疗后再次获得完全缓解。我们的经验证实了单纯放射治疗的低致瘤潜力;在本系列中观察到的4例继发性肿瘤(急性非淋巴细胞白血病)中,只有1例接受过放射治疗。本研究结果证实了单纯放疗对I期患者的疗效,而II期患者的治疗方法仍存在争议。短期化疗与根治性放疗相结合可能是降低复发率和治疗引起并发症发生率的最佳选择。