改良的ProMACE/CytaBOM方案治疗非霍奇金淋巴瘤的疗效观察

目的:探讨改良的ProMACE/CytaBOM方案治疗高度恶性非霍奇金淋巴瘤及中度恶性非霍奇金淋巴瘤的疗效.方法:采用改良的ProMACE/CytaBOM方案治疗16例高度恶性非霍奇金淋巴瘤及中度恶性非霍奇金淋巴瘤患者,其中高度恶性9例,7例为初发患者,2例为复发患者;中度恶性7例为复发患者. 结果:7例高度恶性非霍奇金淋巴瘤及中度恶性复发性非霍奇金淋巴瘤达到完全缓解( CR率43.7%),6例达到部分缓解( PR率37.5%),总有效率为81.2%;目前8例仍生存,其中生存时间最长达42个月(2例),仍处于CR期.毒副作用主要为消化道症状、轻度肝功能异常以及骨髓抑制.结论:改良的ProMACE/CytaBOM方案对部分高度恶性非霍奇金淋巴瘤及中度恶性复发性非霍奇金淋巴瘤患者效果好,毒副作用较轻,值得推广使用.     

威克治疗老年中高度恶性非霍奇金淋巴瘤疗效观察

目的:研究小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤的临床疗效及不良反应.方法:采用小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤14例.其中弥漫性大细胞型4例,弥漫性小裂细胞型3例,弥漫性大小细胞混合型2例,免疫母细胞型3例,淋巴母细胞型1例,小无裂细胞型1例.恶性程度为中、高度.分期为Ⅱ期～Ⅳ期.结果:CR3例,占21.4%;PR8例,占57.1%;有效率为78.6%.主要毒副作用为骨髓抑制和胃肠道反应,对肝功能影响轻微.结论:小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤近期疗效满意,毒副作用小,可在门诊治疗,费用低廉,值得临床推广.     

改良的ProMACE／CytaBOM方案治疗非霍奇金淋巴瘤的疗效观察

目的：探讨改良的ProMACE／CytaBOM方案治疗高度恶性非霍奇金淋巴瘤及中度恶性非霍奇金淋巴瘤的疗效。方法：采用改良的ProMACE／CytaBOM方案治疗16例高度恶性非霍奇金淋巴瘤及中度恶性非霍奇金淋巴瘤患者，其中高度恶性9例，7例为初发患者，2例为复发患者；中度恶性7例为复发患者。结果：7例高度恶性非霍奇金淋巴瘤及中度恶性复发性非霍奇金淋巴瘤达到完全缓解（CR率4．3．7％），6例达到部分缓解（PR率37．5％），总有效率为81．2％；目前8例仍生存，其中生存时间最长达42个月（2例），仍处于CR期。毒副作用主要为消化道症状、轻度肝功能异常以及骨髓抑制。结论：改良的ProMACE／CytaBOM方案对部分高度恶性非霍奇金淋巴瘤及中度恶性复发性非霍奇金淋巴瘤患者效果好，毒副作用较轻，值得推广使用。     

威克治疗老年中高度恶性非霍奇金淋巴瘤疗效观察

目的：研究小剂量长疗程口服国产三好威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤的临床疗效及不良反应。方法：采用小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤14例,其中弥漫性大细胞型4例,弥漫性小裂细胞型3例,弥漫性大小细胞混合型2例,免疫母细胞型3例,淋巴母细胞型1例,小无裂细胞裂1例。恶性程度为中、高度。分期为Ⅱ期－Ⅳ期。结果：CR3例,占21．4％;PR8例,占57．1％,有效率为78．6％。主要毒副作用为骨髓抑制和胃肠道反应,对肝功能影响轻微。结论：小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤按期近期疗效满意,毒副作用小,可在门诊治疗,费用低廉,值得临床推广。     

ProMACE／CytaBOM方案治疗中高度非霍奇金淋巴瘤

目的：研究ＰｒｏＭＡＣＥ／ＣｙｔａＢＯＭ方案治疗中、高长恶性非霍奇金淋巴瘤的临床疗效及不良反应。方法：采用ＰｒｏＭＡＣＥ／ＣｙｔａＢＩＯＭ方案治疗非奇金 。其中弥漫性大细胞型２１例，弥漫性小裂细胞型３例弥漫性大小细胞混合型４例，免疫母细胞型３例，淋巴母细胞型２例，小无裂细胞型１例。恶性程度为中高度。分期为Ⅱ～Ⅳ期，结果：ＣＲ２３例，占６７．６％；ＰＲ６例，占１７．６％。有效率为８５．３％。主要毒副     

ProMACE-CytaBOM方案与CHOP方案治疗非霍奇金淋巴瘤的随机对照研究

背景与目的:CHOP方案一直是治疗中、高度恶性非霍奇金淋巴瘤(non鄄Hodgkin蒺slymphoma,NHL)的基本方案,近年有文献报道ProMACE鄄CytaBOM方案可以提高中、高度恶性NHL的完全缓解(completeresponse,CR)率及生存率。本研究中我们比较ProMACE鄄CytaBOM方案与CHOP方案治疗中、高度恶性NHL的疗效与安全性,为中、高度恶性NHL的规范治疗提供依据。方法:选择经病理组织学证实的中、高度恶性NHL的患者146例,随机分为ProMACE鄄CytaBOM组和CHOP组两组,分别采用上述两种方案治疗。两组生存率采用Kaplan鄄Meier法分析,组间比较采用χ2检验。结果:ProMACE鄄CytaBOM组CR29例(39.7%),部分缓解(partialresponse,PR)28例(38.4%),缓解率(responserate,RR,CR+PR)为78.1%(57/73);CHOP组CR23例(31.5%),PR21例(28.8%),RR为60.3%(44/73);两组比较有显著性差异(P<0.05)。ProMACE鄄CytaBOM组患者1、3、5年生存率分别为89.3%、76.2%和45.7%,CHOP组分别为82.1%、51.4%和32.3%,两组比较有显著性差异(P<0.05)。两组出现的主要不良反应是白细胞下降、血小板下降及恶心等,两组比较无显著性差异(P>0.05)。两组各有1例治疗相关性死亡病例。结论:与CHOP方案相比,ProMACE鄄CytaBOM方案疗效较好,不良反应可以耐受,可作为治疗中、高度恶性NHL的     

国产紫杉醇加顺铂治疗复发性非霍奇金淋巴瘤的临床观察

目的:探讨国产紫杉醇联合顺铂的化疗方案对复发性非霍奇金淋巴瘤的治疗效果.方法:采用国产紫杉醇联合顺铂的方案治疗复发性非霍奇金淋巴瘤患者17例,其中,裂细胞型6例,裂-无裂细胞型5例,无裂细胞型3例,淋巴母细胞型3例,分期为Ⅱ～Ⅳ期.结果:17例中CR 5例,PR 7例,NC 4例,PD1例,总有效率为70.6%;主要毒性反应为轻度骨髓抑制,轻度过敏反应及轻度胃肠道反应.结论:国产紫杉醇联合顺铂方案治疗复发性非霍奇金淋巴瘤安全有效,可作为补救治疗方案.     

高度恶性非霍奇金淋巴瘤的治疗

高度恶性非霍奇金淋巴瘤（工作分类）主要包括：弥漫性小无裂细胞性淋巴瘤（ Burkitt′ s, Burkitt′ s-like）和淋巴母细胞性淋巴瘤。这类淋巴瘤占成人非霍奇金淋巴瘤（ non-Hogdkin′ s-lymphoma,NHL）的 10％以下,儿童青少年 NHL的 75％ [1]。恶性程度高,进展快,死亡率高。但积极治疗能获得较高的治愈率。目前国外发达国家已获得 70％以上的治愈率。本文主要概述国外有关这方面的治疗进展。     

ProMACE-CytaBOM方案治疗难治性及复发中高度恶性非霍奇金淋巴瘤的对照研究

目的:观察ProMACE CytaBOM方案治疗复发及难治性中高度恶性非霍奇金淋巴瘤(non Hodgkin’slymphoma,NHL)的临床疗效及毒副反应,并与DICE方案比较。方法:41例复发及难治性中高度恶性NHL患者随机分为两组:治疗组20例,采用Pro MACE CytaBOM方案治疗;对照组21例,采用DICE方案治疗。结果:治疗组与对照组两组CR率分别为35.0%和28.6%,χ2=0.196,P=0.658;两组总有效率分别为70.0%和71.4%,χ2=0.010,P=0.920;经过中位15个月(5～27个月)的随访,两组1、2年总生存率及中位生存期分别为65.0%、34.7%、19个月和64.8%、34.6%、16个月,χ2=0.210,P=0.645;两组1、2年无疾病进展生存率及中位疾病进展时间分别为40.0%、11.4%、11个月和41.9%、17.4%、11个月,χ2=0.000,P=0.964,差异均无统计学意义。两组毒副反应亦相似。结论:ProM ACE CytaBOM方案是复发及难治性非霍奇金淋巴瘤患者的一个有效的解救治疗方案。     

IMEP方案治疗复发性非霍奇金淋巴瘤28例疗效分析

我院 1999年 8月— 2 0 0 2年 8月应用 IFO(异环磷酰胺 )、Mx(米托蒽醌 )、VP1 6 (足叶乙苷 )、P(强的松 )组成 IMEP方案治疗复发的非霍奇金淋巴瘤取得较好的疗效 ,现分析报告如下。1　临床资料1.1　一般资料　本组 IMEP方案 2 8例 ,男性 17例 ,女性 11例 ,年龄 2 1岁～6 5岁 ,平均年龄 4 1.2岁。1.2　诊断依据　所有病例经临床、血液学、骨髓象及淋巴结组织活检病理学检查确诊 ,按国际工作分类 :中度恶性 11例 ,其中弥漫型大细胞 (裂 /无裂 ) 3例 ,滤泡型大细胞为主型 6例 ,弥漫型小裂细胞 2例 ;高度恶性 17例 ,其中免疫母细胞型 10…     

Outcomes of Tisagenlecleucel in Lymphoma Patients With Predominant Management in an Ambulatory Setting

IntroductionChimeric antigen receptor T-cell therapy (CAR T) is a revolutionary adoptive immunotherapy approach in lymphoma; however, substantial resources are necessary for administration and care of these patients. Our institution has administered tisagenlecleucel primarily in an outpatient setting, and here we report our clinical outcomes.Patients and MethodsWe conducted a single institution, retrospective study investigating outcomes of adult lymphoma patients treated with commercial tisagenlecleucel between 10/2017 and 12/2020. We analyzed patient characteristics and outcomes of efficacy and safety including overall response rate, progression-free survival, overall survival and cytokine-release syndrome, neurotoxicity, and hospitalizations.ResultsSeventy-two patients with relapsed or refractory non-Hodgkin lymphoma (NHL) who received commercial tisagenlecleucel were identified; 68 (94.4%) patients received outpatient tisagenlecleucel. The overall response rate was 43% with a complete response observed in 25 patients (34.7%). At a median follow-up of 9.1 months, the median progression-free survival was 3.3 months. Grade 3-4 cytokine release syndrome was not observed in the study group and two patients had grade 3-4 neurotoxicity. Twenty-six patients (36.1%) were admitted within 30 days after infusion with a median length of stay of 5 days. Fourteen patients (19.4%) were admitted within 72 hours of infusion. No patient died of CAR T cell-related toxicity.ConclusionOur experience affirms treatment with tisagenlecleucel in the outpatient setting is safe and feasible with close supervision and adequate institutional experience. After infusion, adverse events were manageable and the majority of patients did not require hospitalization.     

淋巴母细胞淋巴瘤45例临床疗效分析

目的为探讨淋巴母细胞淋巴瘤的合理治疗方法。材料与方法１９８３年１０月至１９９３年１０月间采用以化疗为主加或不加放疗治疗４５例淋巴母细胞淋巴瘤并总结和分析其临床疗效。结果全组治疗的近期疗效有效率为６１．４％，其中完全缓解（ＣＲ）率为３６．４％。随访３～１０年，３７例死亡，８例仍生存。疗后全组１，３，５，７，１０年生存率分别为４０．０％，２６．７％，１９．４％，１９．４％和０％。化疗和放疗综合治疗组的疗后３，５，１０年生存率分别为３１．５％，２６．１％和１９．４％，优于单化疗组，分别为１９．８％，１２．１％和７．８％（Ｐ＜０．００１）。通过对疗后生存率与近期疗效、临床分期、化疗有效病例是否足量化疗及治疗的不同年代间关系的分析显示，近期疗效达ＣＲ者优于部分缓解（ＰＲ）、稳定（Ｓ）和进展（Ｐ）；早期病变局限（Ⅰ，Ⅱ期）优于晚期（Ⅲ，Ⅳ期）病例；加放疗者优于单纯化疗者；有效病例足量化疗者优于不足量化疗者；近年（１９８８年至１９９３）治疗病例的效果优于早年（１９８３年至１９８７年）所治病例的效果。结论以足量化疗为主，辅以放疗的综合治疗，争取首程治疗达到肿瘤完全缓解是提高淋巴母细胞淋巴瘤疗后生存率的重要途径之一     

Outcomes of Transplant-Eligible Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma After Second-Line Salvage Chemotherapy: The Gustave Roussy Experience

IntroductionAfter failure of frontline therapy, patients with relapsed/refractory diffuse large B-cell lymphoma (RR-DLBCL) that does not respond to first-line salvage chemotherapy can be recommended second-line salvage chemotherapy. The available literature in this regard is weak, although many centers routinely offer this type of second-line salvage chemotherapy to their patients.Patients and MethodsThis retrospective study included transplant-eligible patients with RR-DLBCL treated at Gustave Roussy between January 2008 and April 2020. Eligible patients were those who received second-line salvage chemotherapy using R-DHAP or R-ICE in patients who experienced an insufficient partial response, stable disease, or progressive disease in response to first-line salvage chemoimmunotherapy using an alternative regimen.ResultsForty-six RR-DLBCL patients received second-line salvage regimen, which yielded an objective response rate of 33%, median progression-free survival of 2.1 months, and overall survival of 11.4 months. Twelve patients proceeded to autologous stem-cell transplantation (ASCT), of whom 70% remained alive 1 year after ASCT. To explore the impact of transplantation, a multivariate analysis (excluding response to the first-line salvage regimen because this covariate was totally embedded within the transplantation covariate), ASCT was associated with progression-free survival (hazard ratio = 0.16; 95% confidence interval, 0.06-0.42) and overall survival (hazard ratio = 0.27; 95% confidence interval, 0.08-0.88).ConclusionSecond-line salvage chemotherapy with R-DHAP or R-ICE followed by ASCT leads to a favorable outcome in almost one third of patients with RR-DLBCL and offers a median overall survival of approximately 1 year. These data support the administration of second-line salvage chemotherapy followed by ASCT.     

Phase II study of infusional chemotherapy with doxorubicin, vincristine and etoposide plus cyclophosphamide and prednisone (I-CHOPE) in resistant diffuse aggressive non-Hodgkin's lymphoma: CALGB 9255

Background:Patients with resistant diffuse aggressivenon-Hodgkin's lymphoma (DA-NHL) have a poor prognosis. Studies have suggestedinfusional therapy may be beneficial. Patients and methods:This trial used an infusional regimen calledI-CHOPE in resistant patients who had previously received only bolus CHOPE orCHOP regimen. Resistance was defined as: a) primary refractory disease, b)progression on therapy, c) partial response, d) complete remission lastingless than one year. Eligibility criteria included a diagnosis of DA-NHL (IWFE-H), no prior irradiation and adequate organ function. Results:Thirty-seven patients were entered and twenty-nine wereeligible. Reasons for ineligibility were incorrect histology (5) and other(3). The median age was 57 years (range 29–81) with 21 males. Theperformance status scores were: 0 (12 patients); 1 (9 patients); 2 (8patients). Prior therapy consisted of standard CHOP (26 patients), bolus CHOPE(2 patients), high dose CHOP (1 patient). Therapy consisted of a 120 hourcontinuous intravenous infusion of doxorubicin 10 mg/m²/day,vincristine 0.28 mg/m²/day (maximum 0.4 mg/day), and etoposide 48mg/m²/day. Cyclophosphamide 750 mg/m² was given as aniv bolus day 6 and prednisone was given at 100 mg/day p.o. on days 1–5.G-CSF was allowed for myelosuppression. The overall response rate was48% (CR 17%; PR 31%). Freedom from progression was24% at six months and 8% at one year. Survival was 69%at six months and 40% at one year. In an exploratory analysis a priorCR or PR predicted response to I-CHOPE. Twelve of sixteen patients who had aCR/PR on previous therapy responded while two of thirteen who had no priorresponse, responded to I-CHOPE (P= 0.003). The toxicity wastolerable with grade 3–4 hematologic toxicity being leucopenia94% and thrombocytopenia 41%. The grade 3–4non-hematologic toxicities were infection in 28%, phlebitis in11%, and stomatitis in 15%. Conclusions:I-CHOPE can induce responses in this group ofpatients with a poor prognosis, but most were seen in those who had previouslyhad a response to bolus chemotherapy.     

150例早期霍奇金淋巴瘤的综合治疗

目的 对比单纯化疗、单纯放疗与综合治疗对早期霍奇金淋巴瘤(HL)的疗效.方法 回顾性分析150例Ⅰ期或Ⅱ期(早期)HL患者的临床资料,按照初次治疗方式分为单纯化疗组(22例)、单纯放疗组(18例)、化疗联合放疗的综合治疗组(109例)和手术组(1例).化疗方案以ABVD和MOPP为主,放疗方式主要包括受累野放疗、扩大野放疗和次全淋巴结照射.结果 结节硬化型、混合细胞型、淋巴细胞为主型、淋巴细胞消减型和结节性淋巴细胞为主型HL分别为84、39、23、3和1例.全组有72例患者资料完整,可判断预后,其中以欧洲癌症研究和治疗组织及德国霍奇金淋巴瘤研究组标准判断为0分者分别占36.1%和29.2%.全组完全缓解33例,部分缓解109例,疾病稳定5例,疾病进展3例.全组中位随访71.5个月,6年治疗失败率为18.8%,7年总生存率为89.3%.单因素分析显示,综合治疗的疗效显著优于单纯化疗,结节硬化型和混合细胞型的治疗失败风险明显低于淋巴细胞为主型(均P＜0.05).多因素分析显示,治疗方式可以显著影响预后,单纯化疗发生治疗失败的风险是综合治疗的2.52倍(P=0.004).单因素和多因素分析均未发现总生存时间的影响因素.综合治疗组的急性不良反应发生率较单纯化疗组或单纯放疗组高,主要表现为白细胞减低、胃肠道反应和脱发.结论 对于早期HL,综合治疗可降低治疗失败风险,但不良反应较重.     

Radiation therapy in the management of primary malignant lymphoma of the brain

This study reviewed 21 patients with primary malignant lymphoma of the brain. A rapid onset of symptoms was observed in most patients with a median interval of 10 weeks between first symptom and diagnosis. All received cranial irradiation following either gross total removal of tumor (9 patients), biopsy alone (1l patients) or no surgery (1 patient). Two patients received short courses of chemotherapy. Early clinical improvement was commonly observed following commencement of radiation but this was not sustained. Overall survival from diagnosis was 47 % at one year and 16 % at two years. Analysis of treatment parameters failed to indicate any well-defined factors which may have resulted in an improved survival. There was a suggestion that males fared better than females sad that irradiation of the entire brain to a minimum dose of 5000 rad was associated with longer survival.     

Paclitaxel plus topotecan treatment for patients with relapsed or refractory aggressive non-Hodgkin's lymphoma

Background:Used as single agents, paclitaxel and topotecan havedemonstrated promising activity in treating patients with relapsed aggressivenon-Hodgkin's lymphoma (NHL). We conducted a phase II clinical trial toinvestigate the activity and tolerability of the combination of bothdrugs. Patients and methods:Patients with refractory or relapsedaggressive NHL who had previously been treated with a maximum of two priorchemotherapeutic regimens were given intravenous infusions of paclitaxel 200mg/m² over three hours on day one and topotecan 1 mg/m²over 30 minutes daily from days one to five. All patients received dailysubcutaneous injections of filgrastim (granulocyte colony-stimulating factor)5 µg/kg starting 24 hours after the last dose of chemotherapy untilneutrophil recovery. Treatments were repeated every three weeks for a maximumof six courses. Patients who achieved partial remission or complete remission(CR) after at least two courses were offered stem cell transplantation,if eligible. Results:Of the 71 patients eligible for this trial, 66(93%) were evaluable for treatment response. The median age was53 years (range 23 to 74 years). Thirty-six percent of the patients hadpreviously been treated with ara-C/platinum-based regimens, and 48%failed to achieve CR after primary induction therapy. Sixty-seven percent ofthe patients had elevated lactate dehydrogenase levels at the time oftreatment initiation. The overall response rate was 48% (95%confidence interval (95% CI): 36%–61%). Patientswho had primary refractory disease had a response rate of 31%, comparedwith 65% for patients who did not. Similarly, the response rate ofpatients who failed to achieve CR after their most recent previous therapy was37%, compared with a 65% response rate in patients who relapsedfrom a first or second CR. The median duration of response was six months. Atotal of 199 courses were given, with a median of three courses per patient.Neutropenia at levels 500 leukocytes per microliter was observed after32% of the courses, and thrombocytopenia at levels 20,000 plateletsper microliter was observed after 17% of the courses. Grade3–4 neutropenic fever occurred after 6% of the courses.Non-hematologic toxic effects were predominantly grade 1–2. Conclusion:The combination of paclitaxel and topotecan is aneffective first or second line salvage therapy for patients with relapsed orrefractory aggressive NHL who had prior anthracycline- or platinum-basedchemotherapy.     

B细胞淋巴瘤化疗研究现状

非霍奇金淋巴瘤（non—Hodgkin’s lymphoma,NHL）是原发于淋巴结和其他器官淋巴组织的恶性肿瘤,不是单一的疾病,是一组异质性较大的疾病。它有多种形态特征、免疫表型、生物学规律、发展速度和治疗反应各不相同的类型。2001年,在REAL分型的基础上,由世界各国100多位病理学家、血液病学家和肿瘤学家共同参与制订了2001WHO淋巴瘤分类。在2001WHO NHL分类中,NHL分为B细胞、T细胞和NK细胞等类型,尤以B细胞淋巴瘤发病率为高。故我们重点对B细胞淋巴瘤化疗的现状阐述如下。     

探讨Ⅰ，Ⅱ期非霍奇金淋巴瘤的综合治疗

目的探讨Ⅰ，Ⅱ期非霍奇金淋巴瘤（ｎｏｎ－Ｈｏｄｇｋｉｎ＇ｓｌｙｍｐｈｏｍａ，ＮＨＬ）综合治疗的有效方法。材料与方法１９８７年１月～１９８９年１２月收治ＮＨＬ１５２例，分别采用单纯放疗、放疗＋化疗、化疗＋放疗＋化疗、化疗＋放疗和单纯化疗治疗。结果Ⅰ期ＮＨＬ分别采用单纯放疗和放、化综合治疗者，其３，５，７年生存率与复发率相近。而Ⅰ期仅有结内受累者，其３，５，７年生存率单纯放疗组分别为１００．０％，１００．０％，８８．９％，放、化综合治疗组分别为８８．２％，８２．４％，５２．９％，单放组生存率较高，而复发率两组相近；Ⅱ期ＮＨＬ，放、化综合治疗组３，５，７年生存率较单纯放疗组稍高，复发率两组相近，其中高度恶性病例，化疗＋放疗＋化疗组３，５，７年生存率分别为７３．３％，７３．３％，６０．０％，较放疗＋化疗、化疗＋放疗组均高，而复发率较低。结论（１）Ⅰ期ＮＨＬ仅有结内受累者可考虑用单纯放疗。（２）Ⅱ期高度恶性ＮＨＬ推荐化疗＋放疗＋化疗方法。     

早期霍奇金淋巴瘤的综合治疗

霍奇金淋巴瘤(HL)已成为一种可以治愈的疾病,目前研究的重点在于不增加疾病死亡率的前提下,降低治疗引起的并发症.最近10～15年,开展了Ⅰ～Ⅱ期HL综合治疗的系列随机研究,比较综合治疗和单纯放疗或单纯化疗的疗效,并研究综合治疗时的最佳化疗方案和化疗周期数、照射靶区大小和照射剂量.综合治疗和单纯放疗或单纯化疗比较,显著改善了早期HL无病生存率10%～15%,但未提高总生存率.预后好:早期HL行单纯放疗或2～4周期ABVD方案化疗加受累野照射;预后不良:早期HL行4～6周期ABVD化疗加受累野照射.