[Sequential polychemotherapy and large-field radiotherapy of non-Hodgkin's lymphoma].

Strahlentherapie Pub Date : 1985-04-01
R Kuse, H P Heilmann, A Calavrezos, K Hausmann
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Abstract

The combination of polychemotherapy and large-field radiotherapy essentially promoted the improved total results achieved during the period of 1976 and 1982 in 272 patients with non-Hodgkin's lymphomas (NHL) of low and high malignancy. In case of centroblastic-centrocytic (cb/cc) NHL of stages II A/III A, the recurrence-free survival after radiotherapy (n = 21) could be increased by the combined method (n = 25) from 17% to 60%, and the probability of seven-year survival could be improved from 70% to 90%. All of the ten initially irradiated patients in the stages I A/II A/III A of centrocytic (cc) NHL suffered from a recurrence, whereas the development seems to be more favorable in the five patients submitted to combined treatment who had only one recurrence. The recurrence-free seven-year survival of the highly malignant NHL in stage I A/II A increased from 40% after unique radiotherapy (n = 15) to 70% after combined therapy (n = 39), the survival probability increased from 55% to 75%. Despite the partly insufficient therapy results after unique radiotherapy and polychemotherapy, the combined method has largely contributed to achieve after eight years the total survival rates of 76% for cb/cc NHL (n = 123) and of 55% for the highly malignant immunoblastic NHL (n = 57), centroblastic NHL (n = 35) and NHL with uncertain classification, whereas the cc-NHL (n = 36) hitherto has a relatively unfavorable prognosis with only 29%.

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【非霍奇金淋巴瘤序贯多化疗及大视野放疗】。
综合化疗与大野区放疗的结合,从本质上促进了1976年至1982年272例低恶性和高恶性非霍奇金淋巴瘤(NHL)患者总疗效的改善。对于II期A/III期A的着丝细胞-着丝细胞(cb/cc) NHL,联合放疗法(n = 25)可将放疗后无复发生存率(n = 21)从17%提高到60%,将7年生存率从70%提高到90%。10例初始放疗的ⅰA/ⅱA/ⅲA期单核细胞(cc) NHL患者均出现复发,而接受联合治疗的5例只有一次复发的患者的进展似乎更有利。高度恶性NHL I期A/II期A的无复发7年生存率从单纯放疗后的40% (n = 15)提高到联合治疗后的70% (n = 39),生存率从55%提高到75%。尽管单一放化疗后的治疗效果部分不足,但联合方法在很大程度上有助于实现cb/cc NHL (n = 123)的8年后总生存率为76%,高度恶性免疫母细胞NHL (n = 57),中心母细胞NHL (n = 35)和分类不确定的NHL的55%,而cc-NHL (n = 36)迄今为止预后相对不利,仅为29%。
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