Two cycles of escalated BEACOPP followed by four cycles of ABVD utilizing early-interim PET/CT scan is an effective regimen for advanced high-risk Hodgkin's lymphoma.
两个周期逐步升级的 BEACOPP,然后是四个周期的 ABVD,利用早期中期 PET/ct扫描是治疗晚期高风险霍奇金淋巴瘤的有效方案。

摘要

BACKGROUND:Escalated combination therapy with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone (escBEACOPP) regimen is superior to cyclophosphamide, vincristine, procarbazine and prednisone alternating with doxorubicin, bleomycin, vinblastine and dacarbazine (COPP-ABVD) for advanced-stage Hodgkin's lymphoma (HL) patients. However, the original schedule of eight cycles of escBEACOPP was associated with significant toxicity. This study was conducted in an attempt to reduce the toxicity of the original schedule, while attempting to preserve improved initial tumor control.
PATIENTS AND METHODS:Forty-five newly diagnosed patients with advanced-stage HL and International Prognostic Score > or = 3 received two initial cycles of escBEACOPP and then were evaluated by positron emission tomography (PET)/computed tomography scan. If a good imaging response was obtained, they were treated by four cycles of ABVD.
RESULTS:Following the first two cycles of escBEACOPP, the overall response was 100% and at the end of all therapy, 40 (89%) patients were in complete response (disappearance of all clinical evidence of disease and PET negativity), three (7%) in partial response (PET-positive residual lesions and a size reduction of the majority of large masses by >50%), while two (4%) had progressive disease. After a median follow-up of 48 months, progression-free survival (PFS) and overall survival at 4 years were 78% and 95%, respectively. The 4-year PFS for early PET-negative patients (n = 31) and early PET-positive patients (n = 13) were 87% and 53%, respectively (P = 0.01).
CONCLUSIONS:These data indicate that combined escBEACOPP-ABVD may improve the outcome in patients with high-risk advanced HL. The potential benefit of early-interim PET activity as a guide to continuing therapy in these patients merits further study in the future.

译文

背景: 博莱霉素、依托泊苷、多柔比星、环磷酰胺、长春新碱、普鲁巴嗪和泼尼松 (escBEACOPP) 方案的逐步联合治疗优于环磷酰胺、长春新碱、普鲁巴嗪和泼尼松与阿霉素、博莱霉素交替治疗, 长春碱和达卡巴嗪 (COPP-ABVD) 治疗晚期霍奇金淋巴瘤 (HL) 患者。然而,八个周期的 escBEACOPP 的原始时间表与显著的毒性有关。进行这项研究是为了减少最初计划的毒性,同时试图保持改善的初始肿瘤控制。
患者和方法: 45 名新诊断的晚期 HL 患者和国际预后评分> 或 = 3 分的患者接受了两个最初的 escBEACOPP 周期,然后通过正电子发射断层扫描 (PET) 进行评估 /计算机断层扫描。如果获得了良好的成像反应,他们将接受四个周期的 ABVD 治疗。
结果: 在 escBEACOPP 的前两个周期之后,总反应为 100%,在所有治疗结束时,40 (89%) 患者有完全反应 (疾病和 PET 阴性的所有临床证据消失),部分反应中有三个 (7%)(PET 阳性的残余病变和大多数大型肿块的尺寸缩小> 50%),而两个 (4%) 患有进展性疾病。中位随访 48 个月后,无进展生存期 (PFS) 和 4 年总生存期分别为 78% 和 95%。早期 PET 阴性患者 (n = 31) 和早期 PET 阳性患者 (n = 13) 的 4 年 PFS 分别为 87% 和 53% (P = 0.01)。
结论: 这些数据表明,联合 escBEACOPP-ABVD 可以改善高危晚期 HL 患者的预后。早期中期 PET 活动作为这些患者继续治疗的指南的潜在益处值得将来进一步研究。

BEACOPP

肿瘤 霍奇金淋巴瘤 治疗方法
概述  :  

BEACOPP化疗方案(Bleomycin+ etoposide+ doxorubicin+ cyclophosphamide+ vincristine+ procarbazine+ prednisone),即:博来霉素+依托泊苷+阿霉素+环磷酰胺+长春新碱+甲基苄肼+泼尼松。   霍奇金淋巴瘤(Hodgkin lymphoma , HL)是起源于淋巴造血组织的恶性肿瘤。在我国,HL的发病率不似欧美国家之高,但该病却是最早可被治愈的肿瘤之一

Bleomycin   /,bliə'maɪsɪn/

释    义   n. [药] 争光霉素,[微][药] 博来霉素

例    句   DNA single-strand, breakage following Bleomycin treatment of P388 cells was studied by the method in vitro. 应用体外实验方法对博来霉素引起P388白血病细胞DNA单链断裂效应进行了探讨。


Etoposide 

释    义   n. 依托泊苷

例    句   To investigate the effect of Etoposide alone maintenance chemotherapy for small cell lung cancer (SCLC). 探讨依托泊苷单药维持化疗对小细胞肺癌的疗效及对生活质量的影响。


Doxorubicin   /,dɑksə'rʊbɪsɪn/

释    义   n. 阿霉素;亚德里亚霉素

例    句   This translates into enhanced therapeutic efficacy for drugs like doxorubicin that have intracellular site of action. 继而又转化成提高阿霉素这类作用于细胞内位点药物的治疗效果。


Cyclophosphamide   /,saɪklə'fɑsfə,maɪd/

释    义   n. [药] 环磷酰胺

例    句   Treatment with immunosuppressants such as rituximab, azathioprine and cyclophosphamide resulted in a marked reduction in antibody levels and relapse rates. 免疫抑制剂治疗,如利妥昔单抗,硫唑嘌呤和环磷酰胺,明显减少抗体水平和复发率。


Vincristine   英 /vɪn'krɪstiːn/   美 /vɪn'krɪs,tin/

释    义   n. [药] 长春新碱(一种抗肿瘤药)

例    句   Asiaticoside, as a biochemical modulator, may induce apoptosis, and enhance anti tumor activity of vincristine in cancer cells, might be useful in cancer chemotherapy. 积雪草甙可诱导肿瘤细胞凋亡,并与长春新碱显示协同作用,有可能作为生化调节剂应用于肿瘤化。


Procarbazine   /prəu'kɑ:bəzi:n, -zin/

释    义   n. 甲基苄肼;甲苄肼(一种抗肿瘤药)

例    句   Procarbazine, nitrogen mustard, and ifosfamide, which can increase risk for myelodysplastic syndromes and acute myelogenous leukemia. 丙卡巴肼、氮芥和异环磷酰胺:可增加患骨髓增生异常综合症和急性粒细胞白血病的风险。


Prednisone   英 /'prednɪzəʊn/   美 /'prɛdnɪzon/

释    义   n. [药] 泼尼松(肾上腺皮质激素),

例    句   Without adrenal function, eat prednisone what to side effect there is? 没有肾上腺功能,吃泼尼松有哪些副作用?

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