{"title":"儿童霍奇金淋巴瘤患者的预后和预后因素:一项单中心研究","authors":"Nesreen Ali, Mohamed Mansour, Ehab Khalil, Emad Ebeid","doi":"10.1186/s43046-023-00189-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hodgkin lymphoma (HL) is a highly curable malignant tumor. Risk-adapted treatment for children with HL aims to maximize survival while minimizing toxicity. The purpose of this study is to evaluate the outcome and prognostic characteristics of Egyptian pediatric HL patients treated at the National Cancer Institute (NCI), Cairo University.</p><p><strong>Methods: </strong>All newly diagnosed cases of classic HL treated between January 2016 and December 2018 were included in this study.</p><p><strong>Results: </strong>The median age at initial presentation was 8 years in 69 eligible individuals, with a male-to-female ratio of 4.7:1. Eighteen percent of patients had an elevated erythrocyte sedimentation rate (ESR) of more than 50, 42% had more than three lymph node (LN) group involvements, 18.8% had bulky disease, 52.2% were at an advanced stage, and 34% had B symptoms. Age > 15 years, B symptoms, > 3 LN group involvement, extra-nodal disease, and advanced stages significantly affected the overall survival rate (OS) (P-values = 0.03, 0.033, 0.008, 0.017, and 0.032). There was no statistically significant difference between patients who got combined modality therapy (CMT) and those who received chemotherapy alone (3-year OS and event-free survival (EFS) were 95.5% and 87.6% vs. 89.9% and 83.3%, P-values of 0.70 and 0.90). Patients with an interim-negative positron emission tomography-computed tomography (PET-CT) had a 3-year OS of 94.7%, compared to 74.1% in patients with an interim-positive PET-CT (P = 0.06), suggesting that rapid early response (RER) is a significant prognostic factor. There was no statistically significant survival difference between patients with a negative interim PET-CT who got CMT and those who received chemotherapy alone (3-year OS and EFS: 100% and 88.2% vs. 95% and 90%; P = 0.35 and 0.70, respectively). Three-year OS was 93.3% and 100%, and EFS was 74.3% and 100% (P = 0.495 and 0.196%) for those who got 15 Gy versus those who received 20 Gy or more, respectively. At the end of the study, the OS and EFS at 3 years for the whole group were 91.9% and 83.6%.</p><p><strong>Conclusion: </strong>Treatment with risk- and response-adaptive treatment should be the standard of care for treating pediatric patients with HL.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"35 1","pages":"29"},"PeriodicalIF":2.1000,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience.\",\"authors\":\"Nesreen Ali, Mohamed Mansour, Ehab Khalil, Emad Ebeid\",\"doi\":\"10.1186/s43046-023-00189-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hodgkin lymphoma (HL) is a highly curable malignant tumor. Risk-adapted treatment for children with HL aims to maximize survival while minimizing toxicity. The purpose of this study is to evaluate the outcome and prognostic characteristics of Egyptian pediatric HL patients treated at the National Cancer Institute (NCI), Cairo University.</p><p><strong>Methods: </strong>All newly diagnosed cases of classic HL treated between January 2016 and December 2018 were included in this study.</p><p><strong>Results: </strong>The median age at initial presentation was 8 years in 69 eligible individuals, with a male-to-female ratio of 4.7:1. Eighteen percent of patients had an elevated erythrocyte sedimentation rate (ESR) of more than 50, 42% had more than three lymph node (LN) group involvements, 18.8% had bulky disease, 52.2% were at an advanced stage, and 34% had B symptoms. Age > 15 years, B symptoms, > 3 LN group involvement, extra-nodal disease, and advanced stages significantly affected the overall survival rate (OS) (P-values = 0.03, 0.033, 0.008, 0.017, and 0.032). There was no statistically significant difference between patients who got combined modality therapy (CMT) and those who received chemotherapy alone (3-year OS and event-free survival (EFS) were 95.5% and 87.6% vs. 89.9% and 83.3%, P-values of 0.70 and 0.90). Patients with an interim-negative positron emission tomography-computed tomography (PET-CT) had a 3-year OS of 94.7%, compared to 74.1% in patients with an interim-positive PET-CT (P = 0.06), suggesting that rapid early response (RER) is a significant prognostic factor. There was no statistically significant survival difference between patients with a negative interim PET-CT who got CMT and those who received chemotherapy alone (3-year OS and EFS: 100% and 88.2% vs. 95% and 90%; P = 0.35 and 0.70, respectively). Three-year OS was 93.3% and 100%, and EFS was 74.3% and 100% (P = 0.495 and 0.196%) for those who got 15 Gy versus those who received 20 Gy or more, respectively. 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引用次数: 0
摘要
背景:霍奇金淋巴瘤是一种治愈率很高的恶性肿瘤。针对儿童HL的风险适应治疗旨在最大限度地提高生存率，同时尽量减少毒性。本研究的目的是评估在开罗大学国家癌症研究所(NCI)治疗的埃及儿童HL患者的预后和预后特征。方法:选取2016年1月至2018年12月期间收治的所有新诊断的经典HL病例。结果:69例符合条件的患者首次就诊时的中位年龄为8岁，男女比例为4.7:1。18%的患者红细胞沉降率(ESR)升高超过50,42%的患者有超过3个淋巴结(LN)组受累，18.8%的患者有庞大的疾病，52.2%的患者处于晚期，34%的患者有B症状。年龄> - 15岁、bbb3ln组受累、淋巴结外疾病和晚期显著影响总生存率(OS) (p值分别为0.03、0.033、0.008、0.017和0.032)。联合治疗组(CMT)与单纯化疗组(EFS)的3年OS和无事件生存期(EFS)分别为95.5%和87.6% vs 89.9%和83.3%，p值分别为0.70和0.90，差异无统计学意义。正电子发射断层扫描-计算机断层扫描(PET-CT)中期阴性患者的3年OS为94.7%，而PET-CT中期阳性患者的3年OS为74.1% (P = 0.06)，提示快速早期反应(RER)是一个重要的预后因素。中期PET-CT阴性接受CMT的患者与单独接受化疗的患者之间的生存差异无统计学意义(3年OS和EFS: 100%和88.2% vs 95%和90%;P分别= 0.35和0.70)。15 Gy组和20 Gy及以上组的3年OS分别为93.3%和100%，EFS分别为74.3%和100% (P = 0.495和0.196%)。研究结束时，全组3年OS和EFS分别为91.9%和83.6%。结论:风险适应和反应适应治疗应成为儿童HL患者的标准治疗方法。
Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience.
Background: Hodgkin lymphoma (HL) is a highly curable malignant tumor. Risk-adapted treatment for children with HL aims to maximize survival while minimizing toxicity. The purpose of this study is to evaluate the outcome and prognostic characteristics of Egyptian pediatric HL patients treated at the National Cancer Institute (NCI), Cairo University.
Methods: All newly diagnosed cases of classic HL treated between January 2016 and December 2018 were included in this study.
Results: The median age at initial presentation was 8 years in 69 eligible individuals, with a male-to-female ratio of 4.7:1. Eighteen percent of patients had an elevated erythrocyte sedimentation rate (ESR) of more than 50, 42% had more than three lymph node (LN) group involvements, 18.8% had bulky disease, 52.2% were at an advanced stage, and 34% had B symptoms. Age > 15 years, B symptoms, > 3 LN group involvement, extra-nodal disease, and advanced stages significantly affected the overall survival rate (OS) (P-values = 0.03, 0.033, 0.008, 0.017, and 0.032). There was no statistically significant difference between patients who got combined modality therapy (CMT) and those who received chemotherapy alone (3-year OS and event-free survival (EFS) were 95.5% and 87.6% vs. 89.9% and 83.3%, P-values of 0.70 and 0.90). Patients with an interim-negative positron emission tomography-computed tomography (PET-CT) had a 3-year OS of 94.7%, compared to 74.1% in patients with an interim-positive PET-CT (P = 0.06), suggesting that rapid early response (RER) is a significant prognostic factor. There was no statistically significant survival difference between patients with a negative interim PET-CT who got CMT and those who received chemotherapy alone (3-year OS and EFS: 100% and 88.2% vs. 95% and 90%; P = 0.35 and 0.70, respectively). Three-year OS was 93.3% and 100%, and EFS was 74.3% and 100% (P = 0.495 and 0.196%) for those who got 15 Gy versus those who received 20 Gy or more, respectively. At the end of the study, the OS and EFS at 3 years for the whole group were 91.9% and 83.6%.
Conclusion: Treatment with risk- and response-adaptive treatment should be the standard of care for treating pediatric patients with HL.
期刊介绍：
As the official publication of the National Cancer Institute, Cairo University, the Journal of the Egyptian National Cancer Institute (JENCI) is an open access peer-reviewed journal that publishes on the latest innovations in oncology and thereby, providing academics and clinicians a leading research platform. JENCI welcomes submissions pertaining to all fields of basic, applied and clinical cancer research. Main topics of interest include: local and systemic anticancer therapy (with specific interest on applied cancer research from developing countries); experimental oncology; early cancer detection; randomized trials (including negatives ones); and key emerging fields of personalized medicine, such as molecular pathology, bioinformatics, and biotechnologies.
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