Ⅰ、Ⅱ期霍奇金病放射治疗长期生存的分析  

An analysis of long-term survivors with stage Ⅰ,ⅡHodgkin's disease treated by radiotherapy

作　　者：王凤英[1,2,3,2,4] 王洪林[1,2,3,2,4] 潘自强 郭建新 赵森 刘泰福[1,2,3,2,4] 

机构地区：[1]上海医科大学附属中山医院放疗科 [2]上海医科大学附属肿瘤医院放疗科 [3]安徽省淮南矿务局第一矿工医院 [4]江西宜春地区医院

出　　处：《中华放射肿瘤学杂志》1997年第3期174-178,共5页Chinese Journal of Radiation Oncology

摘　　要：目的评价Ⅰ、Ⅱ期霍奇金病采用扩大照射（ＥｘｔｅｎｄｅｄＦｉｅｌｄ，ＥＦ）、次全淋巴结照射（ＳｕｂｔｏｔａｌＮｏｄａｌＩｒａｄｉａｔｉｏｎ，ＳＴＮＩ）及全淋巴结照射（ＴｏｔａｌＮｏｄａｌＩｒｒａｄｉａｔｉｏｎ，ＴＮＩ）不同方案放射治疗的长期疗效。材料与方法１９７４年４月至１９８９年２月收治的１９１例Ⅰ、Ⅱ期霍奇金病患者，所有病例均做大面积不规则野放射治疗。其中ＥＦ共３９例，ＳＴＮＩ共８８例，ＴＮＩ共６４例。结果发现总复发率和野外复发率在ＥＦ组高于ＳＴＮＩ组或ＴＮＩ组（Ｐ＜０．０５），在ＳＴＮＩ和ＴＮＩ组的总复发率和野外复发率大致相同。ＳＴＮＩ及ＴＮＩ组的５年、１０年及１４年生存率均高于ＥＦ组，虽仅ＴＮＩ组的５年生存率较ＥＦ的５年生存率差异有显著性意义（Ｐ＜０．０５），但仍提示ＥＦ组的照射范围是不够的。Ⅰ期病人５年、１０年和１４年生存率分别为９３．２％、８７．５％和７４．５％，Ⅱ期分别为８８．３％、７８．６％和７８．６％。结论本组结果显示早期霍奇金病采用放射治疗有较好的长期生存率，治疗方案宜采用ＳＴＮＩ为好。Purpose To evaluate the survival and recurrent rates of long-term survivors with stage Ⅰ,Ⅱ Hodgkin's disease treated by radiotherapy with different techniques.Materials and Methods From April 1974 to February 1989,191 patients with stage Ⅰ,Ⅱ Hodgkin's disease were treated by radiotherapy using 60 Co with large irregular field technique.39 of the patients were treated with extended field(EF),88 of patients with subtotal nodal irradiation(STNI) and the rest 64 patients with total nodal irradiation(TNI).Results The total recurrence and extra-field recurrence rates in EF group were higher than that in STNI group or in TNI group(P<0.05),but they were near the same in STNI group and TNI group. The 5-,10-,and 14-years survival rates in both STNI and TNI group were higher than EF group. It indicated that the radiation extension was not enough for the EF field. The 5-,10-,14-year survival rates for stage Ⅰ patients were 93.2%,87.5% and 74.5%, respectively,while those for stage Ⅱ were 88.3%,78.6% and 78.6%.Conclusion A good long-term survival rates can be got for the patients with early stage of Hodgkin's diseases treated by radiotherapy,and it is suggested that STNI be used in those cases.

关 键 词：何杰金氏病 放射治疗 预后 影响因素 长期生存率 EF SINI TNI HODGKIN病 

分 类 号：R733.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]