RESUMO
Our data are presented on evaluation of chemoradiotherapy of 365 patients with stage III Hodgkin's disease. Patients with stage IIIA tumors revealed the following significant differences of overall and relapse-free survival (p < or = 0.00001): 15-year overall survival (nodular sclerosis G1) - 95% vs.G2 - 45%; 15-year relapse-free survival: G1 - 86%, G2 - 32%. In stage IIIB group, overall survival (50%) was significantly lower as compared with 70%. Involvement foci significantly regressed by less than 75% (p = 0.044) after 2-4 cycles of preliminary combination chemotherapy. Our results suggest that differentiated criteria be used for prognosis of stage III Hodgkin's disease treatment.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/mortalidade , Doença de Hodgkin/terapia , Adulto , Idoso , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/patologia , Doença de Hodgkin/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Radioterapia Adjuvante , Medição de Risco , Fatores de Risco , Análise de Sobrevida , Resultado do TratamentoRESUMO
The paper evaluates the results of chemoradiaton (2-4 cycles of preliminary treatment to suppress intoxication symptoms plus total, or subtotal exposure of the lymph nodes to tumor-killing doses in cases of intact iliac inguinal nodes) in 89 patients with Hodgkin's disease stage IIIB. The data are evaluated vis-à-vis regression in exposed foci as intoxication symptoms receded. Overall survival was significantly lower (p = 0.044) when tumor regression was well below 75%. Similar trends were reported with regard to relapse-free survival. It is concluded that, with our regimen, combined treatment will not be effective unless 75% or more regression of tumor is assured.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Linfonodos/patologia , Adulto , Idoso , Quimioterapia Adjuvante/métodos , Intervalo Livre de Doença , Esquema de Medicação , Feminino , Doença de Hodgkin/patologia , Humanos , Linfonodos/efeitos dos fármacos , Linfonodos/efeitos da radiação , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Dosagem Radioterapêutica , Radioterapia Adjuvante/métodos , Indução de Remissão/métodos , Resultado do TratamentoRESUMO
Data are presented on radiochemotherapy (1-4 cycles of combined therapy+total (TI) or subtotal (STI) irradiation of lymph nodes) given to 120 patients, with stage III Hodgkin's disease, whose ileoinguinal lymph nodes were intact. Analysis of overall survival of patients with stage III Hodgkin's disease showed that 87% of STI patients survived for 10-years as compared with 73% in TI (p=0.07). What is most important is that 10-year relapse-free survival in STI patients (92%) was significantly higher than that in TI (75%) (p=0.01).
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Linfonodos/efeitos da radiação , Adulto , Idoso , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Virilha , Doença de Hodgkin/patologia , Humanos , Íleo , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Radioterapia Adjuvante , Análise de Sobrevida , Resultado do TratamentoRESUMO
Patients with stage III Hodgkin's disease (110) received 2-3 courses of combination chemotherapy followed by total or subtotal irradiation, or exposure of primarily involved lymph nodes. The study did not include patients with persistent symptoms of intoxication. Overall 5- and 10-year survival rates were 78 and 68%, recurrence-free--75 and 74% respectively.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Linfonodos/patologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Quimioterapia Adjuvante , Intervalo Livre de Doença , Esquema de Medicação , Feminino , Doença de Hodgkin/patologia , Humanos , Linfonodos/efeitos da radiação , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Radioterapia Adjuvante , Análise de Sobrevida , Resultado do TratamentoRESUMO
The relevance of certain factors in therapy of Hodgkin's disease was evaluated in patients with stage III A (232) and III B (97). Among them were age above 45 years, an increase of more than 50% in blood-serum alkaline phosphatase, presence of at least five lesions, lymph node clusters of 5 cm in diameter and more, and male sex, when two introductory courses of combination chemotherapy were used in stage III A or 2-4 courses (stage III B), followed by total or subtotal irradiation of lymph nodes. The prognostic relevance of either factor was further demonstrated by its increased significance when their different combinations were used.
Assuntos
Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/radioterapia , Adolescente , Adulto , Idoso , Terapia Combinada , Feminino , Doença de Hodgkin/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Resultado do TratamentoRESUMO
Patients with stage III (A,B) Hodgkin's disease (366) received chemoradiotherapy consisting of 2-4 courses of combined modality treatment followed by total or subtotal irradiation of lymph nodes. Overall 10-year (84%) and 15-year (79%) and relapse-free 10-year (85%) and 15-year (82%) survival was reported in stage IIIA cases. Subtotal exposure proved relatively more effective in such patients without iliac and inguinal lymph node involvement. If, following combined modality therapy, intoxication symptoms were aborted in stage IIIB patients; fairly good results were obtained after total and subtotal irradiation of lymph nodes or involved areas (10-year (70%) and 15-year (65%) overall and 10-year (75%) and 15-year (75%) relapse-free survival.
