早期霍奇金淋巴瘤的综合治疗

Combined modality therapy for early stage Hodgkin's lymphoma

霍奇金淋巴瘤(HL)已成为一种可以治愈的疾病,目前研究的重点在于不增加疾病死亡率的前提下,降低治疗引起的并发症。最近10-15年,开展了工Ⅰ-Ⅱ期HL综合治疗的系列随机研究,比较综合治疗和单纯放疗或单纯化疗的疗效,并研究综合治疗时的最佳化疗方案和化疗周期数、照射靶区大小和照射剂量。综合治疗和单纯放疗或单纯化疗比较,显著改善了早期HL无病生存率10％-15％,但未提高总生存率。预后好:早期HL行单纯放疗或2-4周期ABVD方案化疗加受累野照射;预后不良:早期HL行4-6周期ABVD化疗加受累野照射。

Hodgkin's lymphoma has become a highly curable disease. The majority of studies over the past few decades were the development of strategies that decrease late morbidity and mortality but retain the same efficacy of current treatment. In recent 10 - 15 years, there are many randomized controlled studies comparing the combined modality therapy and radiotherapy or chemotherapy alone for stage Ⅰ and Ⅱ Hodgkin's lymphoma. On the other hand, most clinical trials focused on the optimal regimens and cycles of chemotherapy, field size and dose of radiation. Combined modality therapy improved significantly disease free survival by 10% - 15% , but not overall survival as compared to radiotherapy alone in early stage Hodgkin's lymphoma. Patients with favorable early stage disease should be treated with two to four cycles of ABVD and involved-field radiation. Patients with unfavorable early stage disease should receive four to six cycles of ABVD followed by involved-field radiation .