OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press64010.17650/1818-8346-2007-0-2-24-30CLINICAL PICTURE AND THERAPYКЛИНИКА И ТЕРАПИЯModern treatment programs for primary Hodgkin's lymphoma and reasons of treatment failureСовременные возможности лечения первичных больных лимфомой Ходжкина и причины неудач леченияDeminaE. A.ДеминаЕ. А.
Russian Federation

Moscow

Москва

TumyanG. S.ТумянГ. С.
Russian Federation

Moscow

Москва

UnukovaE. N.УнуковаЕ. Н.
Russian Federation

Moscow

Москва

KondratievaN. E.КондратьеваН. Е.
Russian Federation

Moscow

Москва

BorodkinaA. G.БородкинаА. Г.
Russian Federation

Moscow

Москва

ZaitsevaT. I.ЗайцеваТ. И.
Russian Federation

Moscow

Москва

MeluzovaO. M.МелузоваО. М.
Russian Federation

Moscow

Москва

ShiriaevS. V.ШиряевС. В.
Russian Federation

Moscow

Москва

N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical SciencesРОНЦ им. Н.Н. Блохина РАМН230520072243023112022231120222007https://oncohematology.abvpress.ru/ongm/article/view/640

Between 1975 and 2005, 566patients (pts) with primary Hodgkin s lymphoma were treated at N.N. Blokhin Cancer Research Center. We analyzed an influence of treatment programs execution on long-term results based on data of treatment efficacy. Median follow-up period was 58 months (range 5 months — 25 years). Deviations of treatment program were registered in 28,6% of pts in cases of execution of full treatment program at Cancer Research Center. The main part of treatment program was performed at Cancer Research Center and the minority of chemotherapy courses was accomplished domiciliary (40,4% pts). In cases of pts examination, choice of therapy and start of treatment at Cancer Research Center, execution of the main part of course was accomplished domiciliary (63,5% pts).

Even increase for more than 6 weeks of the only one interval significantly resulted to reduction of long-term treatment effect. We observed statistically significant decreased of long-term treatment effect in case of reduction the chemotherapy dimension (dose reduction) to 1/3 from predesigned regimen though after achievement of complete remission as well as cancellation of radiotherapy in combined treatment after achievement of complete remission. All deviations indicated above were revealed in 38,8% pts. An exact adherence to modern treatment programs for pts with Hodgkin's lymphoma facilitate to increase effectiveness of therapy.

На основании данных об эффективности терапии 566 первичных больных лимфомой Ходжкина, получавших лечение в РОНЦ им. Н.Н. Блохина РАМН с 1975 по 2005 г., проведен анализ влияния адекватности выполнения протоколов на отдаленные результаты лечения. Медиана наблюдения 58 мес (разброс 5 мес — 25 лет). При проведении всей программы только в РОНЦ нарушения программы терапии отмечены у 28,6% больных; если лечение проводилось преимущественно в РОНЦ и лишь часть курсов химиотерапии по месту жительства — у 40,4%; если в РОНЦ проводились лишь обследование, выбор программы и начало лечения, а основная часть курса проводилась по месту жительства— у 63,5%.

К статистически значимому снижению отдаленных результатов лечения привели увеличение даже одного интервала свыше 6 нед, уменьшение объема полихимиотерапии на 30% от запланированного даже после достижения полной ремиссии и отмена лучевой терапии в комбинированном лечении после констатации полной ремиссии. Указанные нарушения отмечены у 38,8% больных. Строгое соблюдение современных программ лечения лимфомы Ходжкина способствует повышению эффективности терапии этого заболевания.

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