局限期经典型霍奇金淋巴瘤40例预后分析

Prognosis of limited stage classical Hodgkin's lymphoma: A report of 40 cases

目的:分析和总结局限期经典型霍奇金淋巴瘤(classical Hodgkin’s lymphoma,cHL)患者的临床特征及预后。方法:回顾性分析2012年1月—2014年5月在北京大学肿瘤医院淋巴肿瘤内科接受住院治疗且有完整随访资料的40例局限期cHL患者的临床资料。结果:40例cHL患者的中位年龄为34岁(范围:15～62岁)。其中,39例患者接受ABVD方案化疗,1例患者接受增强型BEACOPP方案化疗。14例患者在化疗结束后接受局部放疗。40例患者均在化疗2个周期后接受PET-CT(中期PET-CT)以评价疗效,以最大标准摄取值(maximum standardized uptake value,SUVmax)较治疗前下降≥71%判定为阴性。结果显示,中期PET-CT阴性者33例(82.5%),阳性者7例(17.5%)。中位随访48个月(范围:36～77个月),全组患者的预计5年总生存(overall survival,OS)率为97.1%,预计5年无进展生存(progression-free survival,PFS)率为97.3%。预后的单因素分析结果显示,仅中期PETCT结果与OS(P=0.031)和PFS(P=0.011)相关,其他因素如年龄、B症状、红细胞沉降率、大包块、是否有欧洲癌症研究与治疗组织(European Organization for Research on Treatment of Cancer,EORTC)风险评估的预后不良因素以及是否放疗均与OS和PFS无显著相关性。结论:局限期cHL患者的总体疗效较好,中期PET-CT结果可能预测预后,部分患者可能无须另行放疗。对此结论,尚待设计更加严格的前瞻性随机对照试验进一步验证。

Objective： To investigate the clinical characteristics and prognosis of patients with limited stage classical Hodgkin＇s lymphoma（cHL）.Methods： Clinical data of 40 patients with limited stage cHL treated in Department of Lymphoma of Peking University Cancer Hospital from January 2012 to May 2014 were reviewed.Results： The media age of the 40 patients with cHL was 34 years old（range： 15-62 years）. Of these patients, 39 patients received chemotherapy with ABVD regimen, one patient received chemotherapy with escalated BEACOPP regimen. Fourteen patients received local radiotherapy after chemotherapy. After 2 cycles of chemotherapy, the positron emission computerized tomography-computed tomography（PET-CT）（interim PET-CT, iPET-CT） was conducted for all patients to evaluate the treatment response.The maximum standard uptake value（SUVmax） of iPET-CT decreased more than 71%as compared with that before treatment was considered negative. The results showed that 33（82.5%） patients were negative and 7（17.5%） were positive. The median followup period was 48 months（range： 36-77 months）. The 5-year estimated overall survival（OS） rate and progression-free survival（PFS） rate were 97.1% and 97.3%, respectively.Univariate analysis of prognosis showed that only iPET-CT result was associated with OS（P = 0.031） and PFS（P = 0.011）, and other factors including age, B-symptom,erythrocyte sedimentation rate（ESR）, bulky, with or without European Organization for Research on Treatment of Cancer（EORTC） risk factors, and with or without radiotherapy were not associated with OS and PFS.Conclusion： The treatment outcomes of patients with limited stage cHL are favourable. iPETCT results might predict the prognosis. Radiotherapy might be omitted for some patients.However, further well designed prospective randomized controlled trials are needed to validate the results of this retrospective study.