The place of radiation therapy in the treatment of non‐Hodgkin's lymphomas
The place of radiation therapy in the treatment of non‐Hodgkin's lymphomas
复制标题
放射治疗在非霍奇金淋巴瘤治疗中的地位
作者：
S. Hellman;J. Chaffey;D. Rosenthal;W. Moloney;G. Canellos;A. Skarin
使用霍奇金病作为评估和管理非霍奇金淋巴瘤的模型可能不合适。后一组不同的综合征和疾病在其临床表现上彼此以及与霍奇金病显著不同。生存期必须与无复发生存期分开，因为后者是衡量任何个体治疗有效性的指标。局限性淋巴结淋巴瘤是罕见的，但重要的是要确定，因为它是可能治愈的辐射。通过放射治疗的I期结节性非组织细胞淋巴瘤可获得显著、延长的无复发生存期。所有其他局限性淋巴结淋巴瘤与高比例的患者在治疗门户之外复发相关。全身照射是一种有用的全身性药剂，可导致III期或IV期结节性淋巴瘤在很长一段时间内消退。化疗似乎对结节性淋巴瘤的价值有限，没有明确的证据表明联合化疗比单一药物更有效。在弥漫性淋巴瘤中，积极的化疗显示出更多的希望，弥漫性组织细胞淋巴瘤具有延长的无复发生存期。
The use of Hodgkin's disease as a model for the evaluation and management of the non‐Hodgkin's lymphomas may not be appropriate. This latter group of different syndromes and diseases differs significantly in their clinical presentation from each other as well as from Hodgkin's disease. Survival must be separated from relapse‐free survival since the latter is a measure of the effectiveness of any individual therapy being applied. Localized nodal lymphoma is uncommon, but important to identify since it is potentially curable by irradiation. Stage I nodular, non‐histiocytic lymphomas treated by radiation results in significant, extended, relapse‐free survival. All other localized nodal lymphoma is associated with a high proportion of patients relapsing outside the treatment portal. Whole body irradiation is a useful systemic agent causing regression for an extended period of time in stage III or stage IV nodular lymphoma. Chemotherapy seems to have a limited value in nodular lymphomas, with no clear evidence that combination chemotherapy is more effective than single agents. In diffuse lymphomas, aggressive chemotherapy shows more promise, with diffuse histiocytic lymphoma having extended relapse‐free survival.