早期霍奇金病综合治疗中受累野照射的临床疗效  

Comparison of preliminary results of involved-field with extended field radiotherapy combined with chemotherapy for early stage Hodgkin′s disease

作　　者：王维虎[1] 李晔雄[1] 宋永文[1] 金晶[1] 刘跃平[1] 王淑莲[1] 周立强[1] 刘新帆[1] 余子豪[1] 韩嘉珠[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院放射治疗科,北京100021

出　　处：《中华肿瘤杂志》2006年第3期218-221,共4页Chinese Journal of Oncology

摘　　要：目的评价Ⅰ、Ⅱ期霍奇金病(HD)患者综合治疗时受累野照射的疗效和毒副作用,并与扩大野照射进行比较。方法早期HD88例,根据AnnArbor分期,ⅠA期12例(13.7%),ⅡA期56例(63.6%),ⅡB期20例(22.7%)。全部患者接受化疗和放疗综合治疗,先化疗后放疗患者83例,先放疗后化疗患者5例。化疗多采用ABVD或ABVD/MOPP方案;受累野照射42例,扩大野照射46例。结果全组有6例膈上原发HD治疗后复发,受累野组和扩大野组各3例。扩大野组有1例照射野内复发,受累野组有1例在邻近照射部位的腋窝复发,其余4例患者均表现为结外器官或膈下淋巴结受侵。全组患者1、2、3年总生存率分别为100.0%、98.6%和96.3%,受累野组患者分别为100.0%、97.1%和97.1%,扩大野组患者分别为100.0%、100.0%和95.8%,两组生存率差异无统计学意义(P=0.86)。受累野组1、2、3年无进展生存率分别为97.6%、94.8%和91.7%,扩大野组分别为97.8%、93.2%和93.2%,两组无进展生存率差异无统计学意义(P=0.65)。发生Ⅰ度和Ⅱ度白细胞减少症者,受累野组3例(7.2%),扩大野组9例(19.5%,P=0.089)。结论Ⅰ、Ⅱ期HD患者进行综合治疗时,采用受累野照射可获得与扩大野照射相同的疗效,且能减少并发症的发生。Objective To evaluate whether involved-field （IF） radiotherapy is equally effective and less toxic in comparison with extended-field （EF） radiotherapy for patients with early-stage Hodgkin＇ s disease （HD） who received combined modality therapy. Methods The data of 88 early-stage HD patients treated with combined modality therapy were retrospectively reviewed. According to Ann Arbor classification, 12 patients （13.7%） had stage ⅠA disease, 56 stage ⅡA （63.6%）, and 20 ⅡB （22.7%）. Forty-two （47.7%） patients underwent involved field radiotherapy （IF group）, whereas the other 46 （52. 3% ） received extended field radiotherapy （ EF group）. Results Of 6 patients who developed recurrence, 3（7.1% ） were in IF group and the other 3 （6.5%） in EF group. Only one patient＇s recurrence developed inside the radiation field in EF group. Three patients （7.2%） in IF group and 9 （ 19.5% ） in EF group had WHO grade 1 and 2 leukopenia （ P = 0. 089 ）. Overall survival rate at 1-, 2- and 3-year was 100. 0%, 97.1%, and 97. 1% in IF group versus 100. 0%, 100 %, and 95.8% in EF group （P =0. 86）, respectively. Freedom from progression survival rate at 1-, 2- and 3-year was 97.6%, 94.8%, and 91.7% in IF group versus 9 7.8 % , 9 3.2 % , and 9 3.2 % in EF group （ P = 0.6 5 ） , respectively. Conclusion Compared with extended-field radiotherapy, involved-field radiotherapy is equally effective and less toxic for patient with early-stage Hodgkin＇s disease treated with combined modality therapy.

关 键 词：霍奇金病 综合治疗 受累野照射 

分 类 号：R733.1[医药卫生—肿瘤]