Terapevticheskii arkhiv · 1998
[Total irradiation of the liver in treating patients with lymphogranulomatosis].
Аннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Balashov A T, Miasnikov A A, Korytova L I
Аннотация
AIM: The study of efficiency of radiation in specific affection of the liver in lymphogranulomatosis (LGM).
MATERIALS AND METHODS: 212 LGM patients were examined for hepatic lesions using x-ray, radiological, cytochemical and histological investigations of the biopsies. Coagulation, alkaline phosphatase, copper and ceruloplasmin in the serum were measured to evaluation the disease activity. All the patients received polychemotherapy (PCT). Irradiation of the liver in the total focal dose 36-44 Gy was performed in confirmed involvement of the liver as adjuvant to PCT.
RESULTS: Specific liver lesions were detected in 6.1% of patients at primary examination and in 15.6%--at follow-up. Liver lesions occurred most frequently in mixed-cell variant of LGM and lymphoid depletion. Eradication of liver lesion after PCT was achieved in 15.4%. Subsequent radiation produced a complete remission in 100% of patients with diffuse and 80% of patients with large-focal liver lesion. In detection of liver involvement at the time of LGM progression eradication and remission were achieved in 70 and 50% of patients, respectively. From 30% of patients with liver lesions resistant to PCT and radiation, 15% had stable disease. The survival did not depend on eradication of liver lesion.
CONCLUSION: In involvement of the liver its radiation is indicated for all the patients with new-onset LGM. In the recurrence, liver radiation is recommended for those in whom the liver is the only extranodal lesion.
MATERIALS AND METHODS: 212 LGM patients were examined for hepatic lesions using x-ray, radiological, cytochemical and histological investigations of the biopsies. Coagulation, alkaline phosphatase, copper and ceruloplasmin in the serum were measured to evaluation the disease activity. All the patients received polychemotherapy (PCT). Irradiation of the liver in the total focal dose 36-44 Gy was performed in confirmed involvement of the liver as adjuvant to PCT.
RESULTS: Specific liver lesions were detected in 6.1% of patients at primary examination and in 15.6%--at follow-up. Liver lesions occurred most frequently in mixed-cell variant of LGM and lymphoid depletion. Eradication of liver lesion after PCT was achieved in 15.4%. Subsequent radiation produced a complete remission in 100% of patients with diffuse and 80% of patients with large-focal liver lesion. In detection of liver involvement at the time of LGM progression eradication and remission were achieved in 70 and 50% of patients, respectively. From 30% of patients with liver lesions resistant to PCT and radiation, 15% had stable disease. The survival did not depend on eradication of liver lesion.
CONCLUSION: In involvement of the liver its radiation is indicated for all the patients with new-onset LGM. In the recurrence, liver radiation is recommended for those in whom the liver is the only extranodal lesion.