Kennedy B J, Fremgen A M, Menck H R
Commission on Cancer of the American College of Surgeons, Chicago, Illinois 60611-2797, USA.
Cancer. 1998 Sep 1;83(5):1041-7. doi: 10.1002/(sici)1097-0142(19980901)83:5<1041::aid-cncr31>3.0.co;2-5.
A national survey of the management of Hodgkin's disease patients based on cases in the National Cancer Data Base (NCDB) provides a basis for evaluating the results of educational and therapeutic programs. These patients are believed to have been drawn from all nationalities, native and migrant, and were reported by hospital cancer registries throughout the United States, including large and small community hospitals, university and other teaching hospitals, military and Veterans Administration (VA) hospitals, and National Cancer Institute (NCI)-Designated Centers.
Data submitted voluntarily to the NCDB were used to determine trends in patterns of patient care across time. For the period 1985-1994, data from 35,033 patients with newly diagnosed Hodgkin's disease were analyzed and separated into two time periods, 1985-1989 and 1990-1994.
Data were analyzed with respect to age, race, histology, stage, treatment, and survival. The majority of patients (83.6%) were white, the age group with the highest incidence was 20-29 years, and nodular sclerosis was the most common histologic type. Staging was reported as a combination of clinical and pathologic stage ("combined stage"). The number of cases of reported stage increased from 51.7% for the years 1985-1989 to 75.7% for the years 1990-1994. Radiation therapy was used primarily to treat patients in Stages I and II, although the overall use of radiotherapy declined by 10% in the later period. The overall observed 5-year survival rate was 83.2%, and the disease specific observed survival rate was 84.9%. Stage for stage, survival was better for younger patients and poorer for older patients.
The survey reflects the actual management of Hodgkin's patients disease. The reported cases for 1994 represent 60.6% of the estimated occurrences for that year in the U.S. There has been a significant improvement in the frequency of use of the staging system. A continuing increase in survival for patients with Hodgkin's disease is occurring. This method of studying disease management provides a measure of educational efforts and guides to developmental research.
基于国家癌症数据库（NCDB）中的病例对霍奇金病患者管理进行的全国性调查为评估教育和治疗项目的结果提供了依据。据信这些患者来自所有国籍，包括本地人和移民，由美国各地的医院癌症登记处报告，其中包括大小社区医院、大学及其他教学医院、军事医院和退伍军人管理局（VA）医院，以及国家癌症研究所（NCI）指定中心。
使用自愿提交给NCDB的数据来确定不同时间患者护理模式的趋势。对于1985 - 1994年期间，分析了35033例新诊断霍奇金病患者的数据，并将其分为两个时间段，即1985 - 1989年和1990 - 1994年。
对年龄、种族、组织学类型、分期、治疗和生存情况进行了数据分析。大多数患者（83.6%）为白人，发病率最高的年龄组为20 - 29岁，结节硬化是最常见的组织学类型。分期报告为临床和病理分期的组合（“联合分期”）。报告的分期病例数从1985 - 1989年的51.7%增加到1990 - 1994年的75.7%。放射治疗主要用于治疗I期和II期患者，尽管后期放射治疗的总体使用量下降了10%。总体观察到的5年生存率为83.2%，疾病特异性观察生存率为84.9%。逐期来看，年轻患者的生存率较好，老年患者的生存率较差。
该调查反映了霍奇金病患者的实际管理情况。1994年报告的病例数占该年美国估计发病数的60.6%。分期系统的使用频率有了显著提高。霍奇金病患者的生存率在持续上升。这种研究疾病管理的方法为教育努力提供了一种衡量标准，并为发展性研究提供了指导。
