Rueda A, Alba E, Ribelles N, Sevilla I, Ruiz I, Miramón J
Oncology Section, Hospital Universitario, Málaga, Spain.
J Clin Oncol. 1997 Mar;15(3):1118-22. doi: 10.1200/JCO.1997.15.3.1118.
Chemotherapy is the standard treatment in advanced Hodgkin's lymphoma and a therapeutic alternative for early stages. Although polychemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) is equivalent or superior to mechloretamine, vincristine, procarbazine, and prednisone (MOPP) in advanced disease, no series have been published using ABVD without associated radiotherapy in early stages. We report the results obtained with the administration of six cycles of ABVD alone in clinical stage I and II disease.
From January 1990 to October 1994, 23 patients with stage I or II Hodgkin's lymphoma were treated with six cycles of ABVD; six patients who met the criteria for mediastinal bulky disease also received radiotherapy to the mediastinum.
After six cycles, 20 complete responses (CRs) and three partial responses (PRs), which became CRs after radiotherapy, were obtained. Toxicity was moderate and manageable. With a median follow-up duration of 37 months (range, 12 to 75), three patients have relapsed and one has died. Overall and progression-free survival rates at 42 months are 95% and 84%, respectively.
Six cycles of ABVD are effective and safe in the treatment of stage I and II Hodgkin's lymphoma, at least in the short term, but long-term observation data are not yet available.
化疗是晚期霍奇金淋巴瘤的标准治疗方法,也是早期霍奇金淋巴瘤的一种治疗选择。尽管在晚期疾病中,多柔比星、博来霉素、长春碱和达卡巴嗪联合化疗(ABVD方案)等同于或优于氮芥、长春新碱、丙卡巴肼和泼尼松联合化疗(MOPP方案),但尚无关于早期霍奇金淋巴瘤单纯使用ABVD方案且未联合放疗的系列报道。我们报告了在临床I期和II期疾病中单纯给予六个周期ABVD方案的治疗结果。
1990年1月至1994年10月,23例I期或II期霍奇金淋巴瘤患者接受了六个周期的ABVD方案治疗;6例符合纵隔大肿块疾病标准的患者也接受了纵隔放疗。
六个周期后,获得了20例完全缓解(CR)和3例部分缓解(PR),后者在放疗后转为CR。毒性为中度且可控。中位随访时间为37个月(范围12至75个月),3例患者复发,1例患者死亡。42个月时的总生存率和无进展生存率分别为95%和84%。
六个周期的ABVD方案治疗I期和II期霍奇金淋巴瘤是有效且安全的,至少在短期内如此,但尚无长期观察数据。