Araştırma Makalesi
Yıl 2021,
Cilt: 8 Sayı: 3, 172 - 178, 28.12.2021
Öz
Hodgkin Lenfoma, tüm lenfomaların %10’unu, erişkin kanserlerin %0.6’sını oluşturan ve çok yüksek kür oranları ile seyreden bir hastalıktır. Çalışmamız, erken evre Hodgkin Lenfoma vakalarımızdaki tedavi yanıtlarının değerlendirilmesi ve sağkalım üzerine etkili olabilecek faktörlerin belirlenmesi için planlandı. Erken evre (evre I-II) Hodgkin Lenfoma tanılı 51 hasta, retrospektif olarak değerlendirildi. Hastaların ortalama yaşı 36.3±13.1 olarak tespit edildi. Hastaların 39’u (%76.5) Türk vatandaşı iken, 12’si (%23.5) ise Suriyeli mültecilerden oluşmaktaydı. ≥50 yaş grubunda 11 hasta (%21.6), 50 yaş altı grupta ise 40 hasta (%78.4) mevcuttu. Vakaların 27’si erkek (%52.9), 24’ü ise kadındı (%47.1). 10 hastada evre I hastalık (%19.6), 41 hastada ise evre II hastalık (%80.4) saptandı. Medyan 36 ay takibi sonrasında (6-60 ay), tüm vakaların 5 yıllık Progresyonsuz sağkalımı (PFS) %92.2, toplam sağkalımı (OS) ise %97.2 olarak tespit edildi. Erken evre iyi prognostik grupta, 2 kür ABVD+20Gy IFRT ile 5 yıllık PFS %92.9, OS ise %100’dür. Erken evre kötü prognostik grupta, 4 kür ABVD+30Gy IFRT ile 5 yıllık PFS %91, OS ise %92.9’dür. Yapılan alt grup analizinde, hem progresyonsuz sağkalım hem de toplam sağkalım üzerine, hastaların ırkı, yaş grubu, cinsiyet, tanı evresi, tanıda B semptomu varlığı, tanıda bulky hastalık varlığı ve histolojik alt tip yönünden anlamlı fark tespit edilemedi. Hem iyi hem de kötü prognostik gruptaki erken evre Hodgkin Lenfoma vakalarımızdaki tedavi yanıtları ve sağ kalım analizleri literatür ile paralellik göstermektedir. Bizim çalışmamız, Şanlıurfa bölgesinde yapılan ilk erken evre Hodgkin Lenfoma analizi olup, bölgemizdeki vakaların takip ve tedavilerine yön vereceği düşünülmektedir.
Anahtar Kelimeler
Erken Evre Hodgkin Lenfoma Progresyonsuz Sağkalım Toplam Sağkalım
Destekleyen Kurum
Destekleyeci kurum yoktur.
Kaynakça
- 1. Smith A, Howell D, Patmore R, et al. Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network. Br J Cancer. 2011;105(11):1684-92.
- 2. Cazzola M. Introduction to a review series: the 2016 revision of the WHO classification of tumors of hematopoietic and lymphoid tissues. Blood. 2016;127(20):2361-4.
- 3. Cosset JM, Henry-Amar M, Meerwaldt JH, et al. The EORTC trials for limited stage Hodgkin's disease. The EORTC Lymphoma Cooperative Group. Eur J Cancer. 1992;28A(11):1847-50.
- 4. Engert A, Plutschow A, Eich HT, et al. Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma. N Engl J Med. 2010;363(7):640-52.
- 5. Network. NCC. Hodgkin Lymphoma (version 2.2019) Available from: https://www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf.
- 6. Eichenauer DA, Aleman BMP, Andre M, et al. Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(4):19-29.
- 7. Ferme C, Eghbali H, Meerwaldt JH, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease. N Engl J Med. 2007;357(19):1916-27.
- 8. Straus DJ, Portlock CS, Qin J, et al. Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA nonbulky Hodgkin disease. Blood. 2004;104(12):3483-9.
- 9. Bakkal TY, Murat SA, Gokcay S, et al. A study on basic demographic and disease characteristics of cancer-diagnosed Syrian refugees treated in the border city of Turkey, Sanliurfa; a hospital-based retrospective case series study. J BUON. 2017;22(6):1591-4.
- 10. Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol. 2007;25(5):571-8.
- 11. Thomas J, Ferme C, Noordijk EM, et al. Comparison of 36 Gy, 20 Gy, or No Radiation Therapy After 6 Cycles of EBVP Chemotherapy and Complete Remission in Early-Stage Hodgkin Lymphoma Without Risk Factors: Results of the EORT-GELA H9-F Intergroup Randomized Trial. Int J Radiat Oncol Biol Phys. 2018;100(5):1133-45.
- 12. Andre MPE, Girinsky T, Federico M, et al. Early Positron Emission Tomography Response-Adapted Treatment in Stage I and II Hodgkin Lymphoma: Final Results of the Randomized EORTC/LYSA/FIL H10 Trial. J Clin Oncol. 2017;35(16):1786-94.
- 13. Radford J, Illidge T, Counsell N, et al. Results of a trial of PET-directed therapy for early-stage Hodgkin's lymphoma. N Engl J Med. 2015;372(17):1598-607.
- 14. Eich HT, Diehl V, Gorgen H, et al. Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin's lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol. 2010;28(27):4199-206.
- 15. von Tresckow B, Plutschow A, Fuchs M, et al. Dose-intensification in early unfavorable Hodgkin's lymphoma: final analysis of the German Hodgkin Study Group HD14 trial. J Clin Oncol. 2012;30(9):907-13.
- 16. Ferme C, Thomas J, Brice P, et al. ABVD or BEACOPPbaseline along with involved-field radiotherapy in early-stage Hodgkin Lymphoma with risk factors: Results of the European Organisation for Research and Treatment of Cancer (EORTC)-Groupe d'Etude des Lymphomes de l'Adulte (GELA) H9-U intergroup randomised trial. Eur J Cancer. 2017;81:45-55.
- 17. Myint ZW, Shrestha R, Siddiqui S, et al. Ten-year survival outcomes for patients with early stage classical Hodgkin lymphoma: An analysis from Kentucky Cancer Registry. Hematol Oncol Stem Cell Ther. 2020;13(1):17-22.
- 18. Aleman BM, van den Belt-Dusebout AW, Klokman WJ, Van't Veer MB, Bartelink H, van Leeuwen FE. Long-term cause-specific mortality of patients treated for Hodgkin's disease. J Clin Oncol. 2003;21(18):3431-9.
- 19. Ng AK, Bernardo MP, Weller E, et al. Long-term survival and competing causes of death in patients with early-stage Hodgkin's disease treated at age 50 or younger. J Clin Oncol. 2002;20(8):2101-8.
- 20. Swerdlow AJ, Higgins CD, Smith P, et al. Myocardial infarction mortality risk after treatment for Hodgkin disease: a collaborative British cohort study. J Natl Cancer Inst. 2007;99(3):206-14.
- 21. Ng AK, Li S, Neuberg D, et al. A prospective study of pulmonary function in Hodgkin's lymphoma patients. Ann Oncol. 2008;19(10):1754-8.
- 22. Woods LM, Rachet B, Coleman MP. Origins of socio-economic inequalities in cancer survival: a review. Ann Oncol. 2006;17(1):5-19.
- 23. Quaglia A, Lillini R, Mamo C, et al. Socio-economic inequalities: a review of methodological issues and the relationships with cancer survival. Crit Rev Oncol Hematol. 2013;85(3):266-77.
- 24. Biasoli I, Castro N, Delamain M, et al. Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients-An analysis from the Brazilian Hodgkin Lymphoma Registry. Int J Cancer. 2018;142(5):883-90.
- 25. Roy P, Vaughan Hudson G, Vaughan Hudson B, et al. Long-term survival in Hodgkin's disease patients. A comparison of relative survival in patients in trials and those recorded in population-based cancer registries. Eur J Cancer. 2000;36(3):384-9.
Yıl 2021,
Cilt: 8 Sayı: 3, 172 - 178, 28.12.2021
Öz
Hodgkin’s Lymphoma constitutes 10% of all the lymphomas and the 0.6% of adult cancers and owns a high treatment success. Our study aims to evaluate the treatment responses in the early Hodgkin’s Lymphoma and to determine factors that may have an impact on the survival. 51 patients with a diagnosis of early (stage I-II) Hodgkin’s Lymphoma were assessed retrospectively. The mean age of the patients was identified as 36.3±13.1. 39 of the patients (76.5%) were Turkish Citizens while 12 of the patients (23.5%) were Syrian refugees. There were 11 patients (21.6%) at the age group of ≥50 and 40 patients (78.4%) under 50. 27 of the cases was male (52.9%) whereas 24 was female (47.1%). Stage I disease was detected in 10 patients (19.6%) and Stage II disease was detected in 41 patients (80.4%). After 36-month median follow-up time (6-60 months), the 5-year PFS was detected as 92.2% and OS as 97.2% in all patients. In the early stage favorable prognostic group, after 2 cycles of ABVD+20Gy IFRT, 5-year PFS is 92.9% and the OS is 100%. In the early stage unfavorable prognostic group, after 4 cycles of ABVD+30Gy IFRT, 5 year PFS is 91% and OS is 92.9%. In the subgroup analysis, no significant difference was observed in terms of PFS and OS among the age group, nationality, gender, the stage at the diagnosis, B symptoms in the diagnosis, Bulky disease and the histological subtype. The treatment responses in early Hodgkin’s Lymphoma cases are similar to the literature. Since our study is the first analysis of the early Hodgkin’s Lymphoma in Şanlıurfa Region, we firmly believe that our study will lead to the treatment and follow-up cases in our region.
Anahtar Kelimeler
Early Stage Hodgkin’s Lymphoma Progression Free Survival Overall Survival
Kaynakça
- 1. Smith A, Howell D, Patmore R, et al. Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network. Br J Cancer. 2011;105(11):1684-92.
- 2. Cazzola M. Introduction to a review series: the 2016 revision of the WHO classification of tumors of hematopoietic and lymphoid tissues. Blood. 2016;127(20):2361-4.
- 3. Cosset JM, Henry-Amar M, Meerwaldt JH, et al. The EORTC trials for limited stage Hodgkin's disease. The EORTC Lymphoma Cooperative Group. Eur J Cancer. 1992;28A(11):1847-50.
- 4. Engert A, Plutschow A, Eich HT, et al. Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma. N Engl J Med. 2010;363(7):640-52.
- 5. Network. NCC. Hodgkin Lymphoma (version 2.2019) Available from: https://www.nccn.org/professionals/physician_gls/pdf/hodgkins.pdf.
- 6. Eichenauer DA, Aleman BMP, Andre M, et al. Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(4):19-29.
- 7. Ferme C, Eghbali H, Meerwaldt JH, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease. N Engl J Med. 2007;357(19):1916-27.
- 8. Straus DJ, Portlock CS, Qin J, et al. Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA nonbulky Hodgkin disease. Blood. 2004;104(12):3483-9.
- 9. Bakkal TY, Murat SA, Gokcay S, et al. A study on basic demographic and disease characteristics of cancer-diagnosed Syrian refugees treated in the border city of Turkey, Sanliurfa; a hospital-based retrospective case series study. J BUON. 2017;22(6):1591-4.
- 10. Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol. 2007;25(5):571-8.
- 11. Thomas J, Ferme C, Noordijk EM, et al. Comparison of 36 Gy, 20 Gy, or No Radiation Therapy After 6 Cycles of EBVP Chemotherapy and Complete Remission in Early-Stage Hodgkin Lymphoma Without Risk Factors: Results of the EORT-GELA H9-F Intergroup Randomized Trial. Int J Radiat Oncol Biol Phys. 2018;100(5):1133-45.
- 12. Andre MPE, Girinsky T, Federico M, et al. Early Positron Emission Tomography Response-Adapted Treatment in Stage I and II Hodgkin Lymphoma: Final Results of the Randomized EORTC/LYSA/FIL H10 Trial. J Clin Oncol. 2017;35(16):1786-94.
- 13. Radford J, Illidge T, Counsell N, et al. Results of a trial of PET-directed therapy for early-stage Hodgkin's lymphoma. N Engl J Med. 2015;372(17):1598-607.
- 14. Eich HT, Diehl V, Gorgen H, et al. Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin's lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol. 2010;28(27):4199-206.
- 15. von Tresckow B, Plutschow A, Fuchs M, et al. Dose-intensification in early unfavorable Hodgkin's lymphoma: final analysis of the German Hodgkin Study Group HD14 trial. J Clin Oncol. 2012;30(9):907-13.
- 16. Ferme C, Thomas J, Brice P, et al. ABVD or BEACOPPbaseline along with involved-field radiotherapy in early-stage Hodgkin Lymphoma with risk factors: Results of the European Organisation for Research and Treatment of Cancer (EORTC)-Groupe d'Etude des Lymphomes de l'Adulte (GELA) H9-U intergroup randomised trial. Eur J Cancer. 2017;81:45-55.
- 17. Myint ZW, Shrestha R, Siddiqui S, et al. Ten-year survival outcomes for patients with early stage classical Hodgkin lymphoma: An analysis from Kentucky Cancer Registry. Hematol Oncol Stem Cell Ther. 2020;13(1):17-22.
- 18. Aleman BM, van den Belt-Dusebout AW, Klokman WJ, Van't Veer MB, Bartelink H, van Leeuwen FE. Long-term cause-specific mortality of patients treated for Hodgkin's disease. J Clin Oncol. 2003;21(18):3431-9.
- 19. Ng AK, Bernardo MP, Weller E, et al. Long-term survival and competing causes of death in patients with early-stage Hodgkin's disease treated at age 50 or younger. J Clin Oncol. 2002;20(8):2101-8.
- 20. Swerdlow AJ, Higgins CD, Smith P, et al. Myocardial infarction mortality risk after treatment for Hodgkin disease: a collaborative British cohort study. J Natl Cancer Inst. 2007;99(3):206-14.
- 21. Ng AK, Li S, Neuberg D, et al. A prospective study of pulmonary function in Hodgkin's lymphoma patients. Ann Oncol. 2008;19(10):1754-8.
- 22. Woods LM, Rachet B, Coleman MP. Origins of socio-economic inequalities in cancer survival: a review. Ann Oncol. 2006;17(1):5-19.
- 23. Quaglia A, Lillini R, Mamo C, et al. Socio-economic inequalities: a review of methodological issues and the relationships with cancer survival. Crit Rev Oncol Hematol. 2013;85(3):266-77.
- 24. Biasoli I, Castro N, Delamain M, et al. Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients-An analysis from the Brazilian Hodgkin Lymphoma Registry. Int J Cancer. 2018;142(5):883-90.
- 25. Roy P, Vaughan Hudson G, Vaughan Hudson B, et al. Long-term survival in Hodgkin's disease patients. A comparison of relative survival in patients in trials and those recorded in population-based cancer registries. Eur J Cancer. 2000;36(3):384-9.
Toplam 25 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Aralık 2021 |
| Gönderilme Tarihi | 28 Temmuz 2020 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 8 Sayı: 3 |
