文档介绍：霍奇金淋巴瘤治疗进展不同预后组的治疗疗效: Europe and North- America Europe Stage Cure Rates (GSHG and EORTC) 早期预后良好组 CS I,IIA,B no risk factors 98% 早期预后不良组 CS I,IIA,B with risk factors 93% 进展期 CS III – IV, Selected CS IIB with ABVD (North America) 65-80% ( intermediate ) Causes of Death among 2733 Patients with Hodgkin ’ s Disease (1960-97) Hodgkin ’ s Disease 383 % Secondary Cancers 200 % MDS 11 % Cardiovascular 148 % Pulmonary 41 % Infection 35 % Trauma/Suicide 16 % Other/Unknown 96 % Total 930 100.% Stanford, R. Hoppe Did we learn from our mistakes over 40 years ? 个体化治疗! ?对于早期患者–如何在保证疗效的情况下尽可能减少副作用? –能否进一步减少化疗疗程?减小放疗剂量? ?晚期患者–如何进一步提高治愈率? 早期预后良好组早期预后良好组: : CS I/II CS I/II 无不良预后因素无不良预后因素早期预后不良组早期预后不良组: : CS I/II CS I/II 有不良预后因素有不良预后因素* * 进展期进展期: : CS III/IV; CS IIB CS III/IV; CS IIB ( LMM ) ( LMM ) * * a) bulk; b) E-lesion; c) high ESR; d) >= 3 involved areas a) bulk; b) E-lesion; c) high ESR; d) >= 3 involved areas GHSG GHSG ––临床预后分组临床预后分组预后不良(Unfavorable) 早期 HL u年龄≥50岁 u≥4个淋巴结区域受侵 u单独 ESR ≥50 uB症状和 ESR ≥30 u纵隔大肿块,或肿块直径大于 10cm u≥2个结外部位受累预后良好(Favorable) 早期 HL u不符合预后不良组条件的其它临床 I/II 期 HL