早期霍奇金淋巴瘤不同治疗模式104例回顾性分析

Retrospective Analysis for 104 Cases of Early-stage Hodgkin′s Lymphoma Treated with Different Modality Therapies

本研究探讨早期霍奇金淋巴瘤(HL)综合治疗模式与扩大野放疗模式的疗效。回顾性分析解放军307医院1987年1月至2010年12月确诊的104例早期HL患者临床资料,分为综合治疗组76例与扩大野放疗组28例,比较两种治疗模式对疗效、生存状况及不良反应的影响。结果表明,104例早期HL患者中位生存85.42个月,综合治疗组与扩大野放疗组的完全缓解率(72.4%vs 71.4%,P=0.924)、总有效率(97.4%vs 96.4%,P=0.779)、5年总生存率(OS,89.5%vs 89.1%,P=0.528)和8年OS(81.3%vs 70.6%,P=0.528)无统计学差异,但两组的5年无进展生存率(PFS,84.2%vs 69.0%,P=0.040)、8年PFS(80.0%vs 55.5%,P=0.040)和5年复发率(28.1%vs 45.6%,P=0.023)有差异。结论:早期HL的综合治疗模式较扩大野放疗模式可提高PFS及降低复发率,但两组OS未见差异。

This paper explored the curative effect of combined modality therapy and extended field radiotherapy for early-stage Hodgkin′s Lymphoma.104 cases of early-stage Hodgkin′s Lymphoma from Jan 1987 to Dec 2010 in PLA Hospital 307 were retrospectively analyzed,including 76 cases in combined modality therapy group and 28 cases in extended field radiotherapy group,and the long-term efficacy and toxicity of two therapy modalities were evaluated.The results showed that the median survival time of 104 cases was 85.42 months,the complete remission rates of combined modality therapy and extended field radiotherapy groups were 72.4% and 71.4% respectively（P=0.924）;the overall response rates of combined modality therapy and extended field radiotherapy groups were 97.4% and 96.4% respectively（P=0.779）;the 5-year overall survival（OS） rates in the 2 groups were 89.5% and 89.1% respectively,and the 8-year OS rates of the 2 groups were 81.3% and 70.6%.No statistical difference was found in above-methioned 2 groups.Moreover,the 5-year progression free survival（PFS） rates of these 2 groups were 84.2% and 69.0%（P=0.04）,and 8-year PFS rates of these 2 groups were 80.0% and 55.5%（P=0.04） respectively,the 5-year relapse rates of these 2 groups were 28.1% and 45.6%（P=0.023） respectively.It is concluded that the combined modality therapy can raise the PFS rate and reduce the relapse rate as compared with extended field radiotherapy for early-stage Hodgkin′s Lymphoma,but there is no difference in the overall survival rate between the 2 groups.