MOPP/ABVD治疗儿童青少年霍奇金病远期疗效观察

Long Term Effect MOPP/ABVD Regimen Chemotherapy for Children and Adolescence with Hodgkin's Disease

[目的]评价中山大学肿瘤防治中心治疗儿童青少年霍奇金病(HD)的远期疗效 ,探讨合理治疗策略。[方法]回顾性分析采用MOPP或ABVD方案或两方案交替加或不加放疗的治疗方法治疗66例4岁～18岁HD的远期疗效。用Kaplan_Meier法计算全组生存率 ,比较单纯化疗与化疗联合放疗的生存率、Ⅰ～Ⅱ A 期和Ⅱ B～Ⅳ B 期患者生存率的差别。[结果]全组66例病人 ,中位随访7.5年(1至19.6年) ,3年总生存率91.83% ;5年总生存率88.23%,10年总生存率83.57 % ,15年总生存率71.94%。Ⅰ～Ⅱ A 期28例,10年总生存率96.15%;Ⅱ B～Ⅳ B 期38例,10年总生存率76.17 %;有显著统计学差异(P=0.0436)。单用化疗组10年总生存率83.63%,化疗 +放疗组10年总生存率84.15 % ,无统计学差异(P=0.8569)。[结论]对儿童青少年HD ,采用MOPP或ABVD方案或联合放疗 ,可获得80%以上治愈率 ,早期治愈率比晚期高。单用化疗与化疗

This study was designed to evaluate long term effect of children and adolescence with Hodgkin's Disease(HD) treated in our cancer center and to explore reasonable therapy strategy. The long term effect of 66 cases patients with HD aged from 4 to 18 year old treated with MOPP or ABVD alone or radiation plus MOPP or ABVD was analyzed retrospectively. Kaplan_Meier method was used to evaluate long term survival rate. The 3, 5, 10 and 15 year survival rates of total cases were 91.83%, 88.23 %, 83.57 % and 71.94%, respectively. 10_year survival rate of the patients with stage Ⅰ～ⅡA was 96.15%, and those with stage ⅡB～ⅣB was 76.17%.There was statistically significant. 10_year survival rate for the chemotherapy alone and chemotherapy plus radiotherapy were 83.63% and 84.15 %, respectively.There was no statistically significant.[Conclusion]Children and adolescence with Hodgkin's Disease can achieve 80% cure rate by using modern standard therapy. The stageⅠ～ⅡA was superior to the stage ⅡB～ⅣB. There was no survival difference between chemotherapy and chemotherapy plus radiotherapy in our study. To adjust therapy intensity for the stageⅠ～ⅡA patients should further be done.