The combined therapy of stage-Ii lymphogranulomatosis: the effect of splenectomy and the time period for achieving full remission on treatment efficacy
Demina, E.A.; Kondrat'eva, N.F.; Pirogova, N.A.
Terapevticheskii Arkhiv 63(7): 40-44
1991
ISSN/ISBN: 0040-3660 PMID: 1788806 Document Number: 385971
In 1982-1986, 72 patients with stage II lymphogranulomatosis received combined treatment according to the following program: 3 cycles of polychemotherapy in accordance with the CVPP scheme plus radiation of all the lymphatic collectors above the diaphragm up to the total radiation dose 35 Gy plus 3 cycles according to the CVPP. Splenectomy was provided to 45 patients; spleen impairment was revealed in 13. The median observation period reached 67 months. Both short- and long-term results of the treatment were analyzed. Neither splenectomy nor specific impairment thereof exerted any effect on the treatment results of this patients' group. The predominance of a number of "favourable" prognostic factors in splenectomized patients produced no effect on the treatment efficacy. It is concluded that in this patients' group, splenectomy is not advisable. A significant relationship was discovered between both survival and duration of the relapse-free course and the times of complete remission attainment. In patients, in whom complete remission was ascertained after 3 cycles of polychemotherapy and before radiotherapy onset, the 7-year survival amounted to 100% whereas the 7-year relapse-free course was recorded in 98% of cases, which is significantly higher than in patients, in whom only partial remission was attained by that time--78 and 68%, respectively (p less than 0.05).