ADJUVANT RADIOTHERAPY TO SITES OF PREVIOUS BULKY DISEASE IN PATIENTS STAGE-IV DIFFUSE LARGE-CELL LYMPHOMA
ADJUVANT RADIOTHERAPY TO SITES OF PREVIOUS BULKY DISEASE IN PATIENTS STAGE-IV DIFFUSE LARGE-CELL LYMPHOMA
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DOI：
10.1016/0360-3016(94)90352-2
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发表时间：
1994-11-15
影响因子：
7
通讯作者：
DIAZMAQUEO, JC
中科院分区：
文献类型：
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作者：
AVILES, A;DELGADO, S;DIAZMAQUEO, JC
目的：探讨晚期弥漫性大细胞淋巴瘤化疗后完全缓解后，对原肿块部位进行辅助放射治疗的价值。方法与材料：218例晚期弥漫性大细胞淋巴瘤患者采用环磷酰胺、表阿霉素、长春新碱、泼尼松、博莱霉素等联合化疗，联合地塞米松、阿糖胞苷、顺铂治疗。155例患者获得完全缓解。88名最初患有大块性疾病的患者被随机分为接受放射治疗(43例)和未接受放射治疗(45例)两组。剂量范围为40-50GY。结果：接受放射治疗的患者没有达到治疗失败的中位时间。5年后，接受联合治疗的患者中有72%的患者仍无病存活，而对照组只有35%。接受辅助放射治疗的患者的5年计划生存率较好：81%，而未接受放射治疗的患者为55%。毒性轻微，可控。未观察到致死性毒副作用。结论：该治疗序列对播散性DLCL患者和大块性疾病患者产生了持久的控制性疾病，毒性可接受。放射治疗在弥漫性DLCL患者中的作用将在大型临床试验中得到证实，但我们认为这种治疗顺序对这种临床情况的患者可能有用。
Purpose: To evaluate the usefulness of adjuvant radiotherapy to sites of previous bulky disease in patients with advanced diffuse large cell lymphoma (DLCL) who were in complete remission after chemotherapy.Methods and Material: Two-hundred and eighteen patients were initially treated with combined chemotherapy CEOP-bleo (cyclophosphamide, epirubicin, vincristine, prednisone, bleomycin) alternating with DAC (dexamethasone, cytosine arabinoside, and cisplatinum). One hundred and fifty-five patients achieved complete remission. Eighty-eight patients with initial bulky disease were randomly assigned to either received (43 patients) or not received radiotherapy (45 patients). Dose ranged from 40-50 Gy.Results: The median time to treatment failure has not been reached in patients who received radiotherapy. At 5 years 72% of the patients treated with the combined therapy remain alive disease in free compared to only 35% in the control group. Projected survival at 5 years was better in the patients with adjuvant radiotherapy: 81% compared to 55% in the patients who received no radiotherapy. Toxicity was mild and manageable. No lethal toxicities were observed.Conclusion: This treatment sequence produced durable control disease in patients with disseminated DLCL and bulky disease with acceptable toxicity. The role of radiation therapy in patients with disseminated DLCL will be confirmed in large clinical trials, but we felt that this sequence of treatment could be useful in patients with this clinical condition.