The management of stage I--II Hodgkin's disease with irradiation alone or combined modality therapy: the Stanford experience.
The management of stage I--II Hodgkin's disease with irradiation alone or combined modality therapy: the Stanford experience.
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单独放疗或联合疗法治疗 I-II 期霍奇金病：斯坦福大学经验。
DOI：
10.1182/blood.v59.3.455.455
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发表时间：
1982
期刊：
影响因子：
20.3
通讯作者：
Henry S. Kaplan
中科院分区：
文献类型：
--
作者：
Richard T. Hoppe;C. Coleman;Richard;Cox;Saul A. Rosenberg;Henry S. Kaplan
在斯坦福大学，1968年至1978年间，230名病理I-II期霍奇金氏病患者接受了前瞻性临床试验，分别采用单纯照射或照射后辅助性联合化疗6个周期。两组患者10年的精算生存率均为84%。在单纯接受放射治疗的患者中，10年的复发率为77%，在综合治疗后为84%[p(Gehan)=0.09]。10年后复发率分别为89%和94%[p(Gehan)=0.56]。评估了几个预后因素，以确定在最初的单纯放射治疗后复发风险高或最终存活率低的患者。全身症状、组织学亚型、年龄和局限性结外病变(E-病变)并不影响患者的预后，也无法确定哪些患者可以通过常规综合治疗来改善生存。纵隔肿块较大(纵隔质量比大于或等于1/3)的患者，单纯放疗的复发率明显低于最初接受综合治疗的患者[10年时分别为45%和81%，p(Gehan)=0.03]。然而，这些患者的10年生存率没有显著差异(84%对74%)。讨论了这些观察结果对早期霍奇金氏病患者治疗的影响。
At Stanford University, between 1968 and 1978, 230 patients with pathologic stage I--II Hodgkin's disease were treated on prospective clinical trials with either irradiation alone or irradiation followed by 6 cycles of adjuvant combination chemotherapy. The actuarial survival at 10 yr was 84% for patients in either treatment group. Freedom from relapse at 10 yr was 77% among patients treated with irradiation alone and 84% after treatment with combined modality therapy [p(Gehan) = 0.09]. Freedom from second relapse at 10 yr was 89% and 94%, respectively [p(Gehan) = 0.56]. Several prognostic factors were evaluated in order to identify patients at high risk for relapse or with poor ultimate survival after initial treatment with irradiation alone. Systemic symptoms, histologic subtype, age, and limited extranodal involvement (E-lesions) did not affect the prognosis of patients and failed to identify patients whose survival could be improved by the routine use of combined modality therapy. Patients with large mediastinal masses (mediastinal mass ratio greater than or equal to 1/3) had a significantly poorer freedom from relapse when treated with irradiation alone than when treated initially with combined modality therapy [45% versus 81% at 10 yr, p(Gehan) = 0.03). The 10-yr survival of these patients, however, was not significantly different (84% versus 74%). The implications of these observations on the management of patient with early stage Hodgkin's disease are discussed.
影响因子：
11.2
作者：
P. Carbone;H. Kaplan;K. Musshoff;D. Smithers;M. Tubiana
通讯作者：
P. Carbone;H. Kaplan;K. Musshoff;D. Smithers;M. Tubiana