早期隔上霍奇金淋巴瘤斗篷野与累及野放疗联合化疗比较

Comparison between Mantle Field Radiotherapy and Involved Field Radiotherapy Combined with Chemotherapy in Patients with Early Supradiaphragmatic Hodgkin's Lymphoma

目的:比较早期隔上霍奇金淋巴瘤(HD)斗篷野与累及野放疗联合化疗的疗效。方法:对35例早期HD患者,先予化疗4个疗程,然后随机分为常规斗篷野放疗(20例)或累及野放疗(15例),剂量为大野30Gy,局部肿块区加至40Gy,放疗后再化疗2个疗程。结果:中位随访58个月。3年总生存率为94.3%。无复发生存率为80.0%。两组3年总生存率及无复发生存率无明显差异。结论:早期隔上HD在化疗基础上,累及野与斗篷野放疗疗效相似,并发症较低。

Objective： To compare the efficacy between Mantle Field Radiotherapy and Involved Field Radiotherapy Combined with Chemotherapy in Patients with Early Supradiaphragmatic Hodgkin＇s Lymphoma （HL）. Methods： Between 1996 and 2001, 35 patients with stage Ⅰ - Ⅱ HL were randomly assigned to receive radiotherapy of 30 Gy mantle field （EF） ＋ 10 Gy to bulky disease （20 cases） or 30 Gy involve field （IF） ＋ 10 Gy to bulky disease （15cases）. All patients received 6 cycles of chemotherapy before and after radiotherapy. Results： The median follow-up time was 58 months （range 36-115）. Overall survival was 94.3%（33/35） and freedom from treatment failure was 80.0%（28/35） at three years. The three-year survival rate revealed no difference for arms EF （95.0%,19/20） and arm IF （93.3%,14/ 15）, respectively. Conclusion： Radiotherapy volume size reduction from EF to IF after chemotherapy for four cycles produces similar results and less toxicity in patients with early-stage supradiaphragmatic HL.