ABVD方案治疗儿童和青少年霍奇金淋巴瘤疗效比较

摘要

Objective The optimal therapeutic regimen for Hodgkin's lymphoma (HL) in adolescents remains unknown.This study compared the long-term outcomes of adolescents and children with HL treated with ABVD regimens.Methods Children and adolescents who were newly-diagnosed with HL were included.Low risk HL used the ABVD regimen for 4 sessions of chemotherapy.The middle risk and high risk HL used ABVD regimen for 6 sessions of chemotherapy.Patients with Low risk HL had complete relief of chemotherapy ended up with the elimination of radiation,and the rest received low dose radiation (IFRT).Results A total of 90 patients were enrolled,including 57 children and 33 adolescents.The percentage of female in adolescent HL was higher (36.6％ vs.18.2％).Compared with the children's HL,the adolescent HL of nodular sclerosing tubercle was more than Nodular lymphocyte type (P =0.011).Stage Ⅳ and high-risk patients were relatively more,but did not reach statistical significance.Adolescents had a higher percentage of stage Ⅳ and high-risk HL than children.After a median follow-up time of 51 months,the 4 years event free survival (EFS) and overall survival (OS) for all patients was (81.6 ± 4.4)％ and (96.1 ± 2.2) ％,respectively.The 4 years EFS in children and adolescents was (80.7 ± 5.7) ％ and (83.4 ± 6.9) ％ (P =0.715),respectively,and the 4 years OS was (94.0 ± 3.4) ％ and 100％ (P =0.122),respectively.Conclusions The clinical features of adolescent HL is different from that of childrenHL.The proportion of high-risk and stage Ⅳ HL was higher in adolescents than in children,however the outcome was similar in the two groups following treatment with ABVD regimens.%目的 青少年霍奇金淋巴瘤(HL)的最佳治疗方案尚不明确.本研究目的是通过总结青少年HL的临床特点、采用ABVD方案治疗的效果,研究其临床疗效及预后.方法 初治儿童和青少年HL患者纳入研究.低危HL采用ABVD方案化疗4个疗程.中、高危HL采用ABVD方案化疗6个疗程.低危HL患者化疗结束达完全缓解后取消放疗,其余患者接受侵犯野低剂量放疗(IFRT).分析临床疗效并与儿童HL治疗结果对比分析.结果 共90例患者入组,其中儿童57例,青少年33例.青少年HL中女性比例较儿童高(36.6％vs.18.2％).与儿童HL相比,青少年HL结节硬化型较多,结节性淋巴细胞为主型较少(P=O.Oll);Ⅳ期和高危患者相对较多,但差异无显著性.中位随访时间51个月,全部患者的4年EFS为(81.6±4.4)％,4年OS为(96.1±2.2)％.儿童组(n=57)和青少年组(n=33)的4年EFS分别为(80.7±5.7)％和(83.4±6.9)％(P=0.715),其4年OS分别为(94.0±3.4)％和100％ (P =0.122).结论 青少年HL与儿童HL的临床特征不同,Ⅳ期和高危型患者比例相对较高,但采用ABVD方案联合放疗治疗后可获得与儿童HL同样好的远期疗效.