目的:恶性淋巴瘤(ML)包括霍奇金淋巴瘤和非霍奇金淋巴瘤通常采用局部放疗(RT)联合自体造血干细胞移植(ASCT)治疗,以防止复发;这种方法的疗效和最佳时机尚不清楚.在这项研究中,日本放射肿瘤学研究小组进行的一项全国调查审查了2011年至2019年的ML病例,以确定是否应将RT添加到ASCT中。重点使用自体外周血干细胞移植(auto-PBSCT),ASCT的主要形式。
方法:该调查涵盖了来自11个研究所的92名患者,并评估组织学ML类型,治疗方案,RT相对于自动PBSCT的时序,和相关的不良事件。
结果:结果表明不良事件没有显着差异,包括骨髓抑制,基于RT相对于自动PBSCT的时序。然而,在auto-PBSCT之前给予RT时,贫血更为普遍,在自动PBSCT后接受RT的患者中,中性粒细胞减少症恢复延迟的发生率更高。
结论:这项研究为ML治疗中自动PBSCT和局部RT的可变实践提供了有价值的见解,强调需要优化这些治疗的时机,以改善患者的预后并减少并发症。
OBJECTIVE: Malignant lymphoma (ML) including Hodgkin\'s lymphoma and non-Hodgkin\'s lymphoma is often treated with local radiation therapy (RT) in combination with autologous hematopoietic stem cell transplantation (ASCT) to prevent relapse; however, the efficacy and optimal timing of this approach is unclear. In this
study, a national survey conducted by the Japanese Radiation Oncology
Study Group reviewed ML cases from 2011 to 2019 to determine whether RT should be added to ASCT, focusing on the use of autologous peripheral blood stem cell transplantation (auto-PBSCT), a predominant form of ASCT.
METHODS: The survey encompassed 92 patients from 11 institutes, and assessed histological ML types, treatment regimens, timing of RT relative to auto-PBSCT, and associated adverse events.
RESULTS: The results indicated no significant differences in adverse events, including myelosuppression, based on the timing of RT in relation to auto-PBSCT. However, anemia was more prevalent when RT was administered before auto-PBSCT, and there was a higher incidence of neutropenia recovery delay in patients receiving RT after auto-PBSCT.
CONCLUSIONS: This
study provides valuable insights into the variable practices of auto-PBSCT and local RT in ML treatment, emphasizing the need for optimized timing of these therapies to improve patient outcomes and reduce complications.