Abrams R A, Liu P J, Ambinder R F, Haulk T L, Korman L T, Herman M G, Jones R J
Department of Oncology, Johns Hopkins Oncology Center, Baltimore, MD 21287-8922, USA.
Radiology. 1997 Jun;203(3):865-70. doi: 10.1148/radiology.203.3.9169718.
To assess the acute toxicity and therapeutic effect of local-regional radiation therapy after bone marrow transplantation performed for lymphoma in resistant relapse.
Twenty-one patients with Hodgkin (n = 12) or non-Hodgkin lymphoma (n = 9) underwent local-regional radiation therapy after bone marrow transplantation. Posttransplantation radiation was delivered to the dominant site of pretransplantation disease. Three patients with Hodgkin lymphoma and four with non-Hodgkin lymphoma underwent radiation therapy for posttransplantation recurrence. Total body irradiation was used in 10 patients. Mean radiation dose was lower in patients who underwent total body irradiation than in those who did not (P = .05).
Nineteen of 21 patients completed local-regional therapy. Nonhematologic toxicity was mild in 20 patients. Hematologic toxicity was severe in five patients, four of whom began radiation therapy with low platelet counts. In-field disease progression occurred in six of 15 patients with relapse, including four with disease progression at the start of radiation therapy. Median progression-free survival was 12 months in patients with Hodgkin lymphoma and 1 month in patients with non-Hodgkin lymphoma.
Posttransplantation local-regional radiation therapy can be safely administered in patients with lymphoma. Severe hematologic toxicity is a concern, however, in patients with low platelet counts.
评估对耐药复发淋巴瘤患者进行骨髓移植后局部区域放射治疗的急性毒性和治疗效果。
21例霍奇金淋巴瘤患者（n = 12）或非霍奇金淋巴瘤患者（n = 9）在骨髓移植后接受了局部区域放射治疗。移植后放疗针对移植前疾病的主要部位进行。3例霍奇金淋巴瘤患者和4例非霍奇金淋巴瘤患者因移植后复发接受了放射治疗。10例患者使用了全身照射。接受全身照射的患者的平均放射剂量低于未接受全身照射的患者（P = 0.05）。
21例患者中有19例完成了局部区域治疗。20例患者的非血液学毒性较轻。5例患者出现严重血液学毒性，其中4例在血小板计数较低时开始放疗。15例复发患者中有6例出现野内疾病进展，包括4例在放疗开始时即有疾病进展的患者。霍奇金淋巴瘤患者的无进展生存期中位数为12个月，非霍奇金淋巴瘤患者为1个月。
淋巴瘤患者移植后可安全地进行局部区域放射治疗。然而，血小板计数低的患者需要关注严重血液学毒性。
