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目的比较膈上型临床Ⅱ期霍奇金病伴纵隔大肿块的３种治疗方法的疗效。材料与方法１９６８年至１９９５年６月收治９９例伴纵隔大肿块临床Ⅱ期的霍奇金病，单放组（ＲＴ）４４例，化疗和放疗组（ＲＴ＋ＣＴ）４２例，化疗加放疗加低剂量肺预防照射组（ＲＴ＋ＣＴ＋ＬＤＬＩ）１３例。照射范围：斗篷野１３例，次全淋巴结照射７６例与全淋巴结照射１０例。病灶区剂量４５～５０Ｇｙ，预防量３５～４０Ｇｙ，肺低剂量照射１５Ｇｙ。化疗采用ＭＯＰＰ或ＭＯＰＰ／ＣＨＯＰ／ＡＢＶＤ交替使用２～６周期。结果ＲＴ、ＲＴ＋ＣＴ和ＲＴ＋ＣＴ＋ＬＤＬＩ组的５年与１０年生存率为７７．０％、７７．０％，８３．４％、７０．６％和１００％、８７．５％（Ｐ＜０．０５）。结论化疗可降低胸腔内复发率。化疗２个周期加次全淋巴结照射加肺低剂量照射组疗效高于另２个组且并发症低。
Objective To compare the therapeutic effects of three treatment methods for supraorbital type II clinical Hodgkin’s disease with mediastinal mass. Materials and Methods From 1999 to June 1995, 99 cases of Hodgkin’s disease in stage II with large mediastinal mass were treated, 44 cases in single-release group (RT), 42 cases in chemotherapy and radiotherapy group (RT+CT), plus chemotherapy and radiotherapy plus low The dose of lung prophylactic irradiation group (RT+CT+LDLI) was 13 cases. Irradiation range: 13 cases with cape field, 76 cases with sub-full lymph node irradiation and 10 cases with total lymph node irradiation. The lesion area dose 45 ~ 50Gy, prevention volume 35 ~ 40Gy, lung low dose irradiation 15Gy. Chemotherapy uses MOPP or MOPP/CHOP/ABVD alternately for 2-6 cycles. Results The 5-year and 10-year survival rates of RT, RT+CT, and RT+CT+LDLI groups were 77.0%, 77.0%, 83.4%, 70.6%, 100%, and 87.5% (P<0.05). . Conclusions Chemotherapy can reduce the recurrence rate in the chest cavity. Two cycles of chemotherapy plus subtotal lymph node irradiation plus low dose lung irradiation were more effective than the other two groups with low complications.