Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti

Cetindag, Mehmet Faik

doi:10.5505/aot.2021.82473

Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti

Mehmet Faik ÇETİNDAĞ (Medipol Mega Üniversite Hastanesi İstanbul, Türkiye)

ACTA ONCOLOGICA TURCICA

37 3

Yıl: 2021 Cilt: 54 Sayı: 1 Sayfa Aralığı: 115 - 127 Metin Dili: Türkçe DOI: 10.5505/aot.2021.82473 İndeks Tarihi: 15-06-2021

Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti

Öz:

Giriş ve amaç: Bu çalışmada 1990 yılında yapılmış Hodgkin lenfoma tezinden yola çıkılarakgünümüzde HL tanı, görüntüleme ve tedavi sindeki güncel gelişim vaka örneklemleri ile incelenecektir.Son 30 yıldaki tedavi endikasyonu değişimleri, radyoterapi tedavi alanlarındaki küçülmeler veradyoterapi doz düşümleri tarihsel süreçler dikkate alınarak karşılaşmalı olarak değerlendirilecektir.Yöntem ve gereçler: Yazarın 1985- 1990 yıları arasında Ankara Numune Hastanesi RadyoterapiKliniğinde tedavisi tamamlanan hastaların demografik ve klinik, özellikleri özetlenecek ve o tarihtekigüncel görüntüleme yöntemleri ve tedavi yaklaşımları, günümüzdeki yaklaşımlarla kıyaslanacaktır.Bulgular: 1985-1990 yılları arasında Ankara Numune Hastanesinde Hodgkin lenfoma tanısı ile tedaviedilen 60 vakanın verileri incelenmiştir. Ortanca yaş 31 olarak bulundu. Evre ve histolojik tip gruplararasında eşit olarak dağılmıştı. Başlangıç tutulum alanlar; servikal-supraklavikular bölge 34 vaka (%56), inguinofemoral 8 vaka (%13), aksiller 7 vaka (%11), mediastinal 5 vaka (%8,2), abdominal 3 vaka (% 5,3), tonsil 2 vaka (%3), primer beyin 1 vaka olarak görüldü. Diafram altı başlayan vakalar totalin% 18 lik bölümüydü. Miks sellüler tip en çok görülen gurubu oluşturdu. Bin dokuz yüz seksenli yıllardaEvre IA ve II A Hodgkin lenfoma da standart tedavi şekli Sub Total Lenfod Işınlama (Mantle, InvertedY) idi. Bu dönemde Hodgkin lenfoma görüntülemesinde kullanılan en gelişmiş yöntem Bi-PedalLenfanjigrafi iken günümüzde FDG PET-CT primer görüntüleme yöntemidir. Bu çalışmada radyoterapialan 58 hastanın 6 sında yineleme olmuştur. Yinelemelerin 4 ü alan dışı, 2 si alan içi olarak raporlanmıştıTartışma ve sonuç: Alan dışı nükslerin fazlalığı ve geniş alan radyoterapi uygulamalarının özellikleçocukluk yaş grubunda oluşturduğu büyüme gelişme gerilikleri, kardiak sorunlar, ikincil kanserlerinartışı gibi yan etkiler araştırmacıları yeni tedavi şekilleri aramaya yöneltmiştir. Günümüzde giderekboyut olarak küçülmüş ve dozu azaltılmış radyoteapi uygulamaları iyi kemoterapi uygulamaları ileeşleştirilmiştir. Hem kemoterapideki iyileşmeler hem de radyoterapi tekniğindeki gelişmeler 5 yıllıkyaşamı %90 seviyelerinin üzerine çıkarırken morbid yan etkiler tarihsel makalelerde anekdot olarakkalmıştır.

Anahtar Kelime:

Hodgkin Lymphoma Treatment; What Has Changed in the Last 30 Years

Öz:

Introduction: In this study, based on the Hodgkin lymphoma thesis made in 1990, current developments in Hodgkin lymphoma diagnosis, imaging and treatment are examined with case samples. Changes in treatment indication in the last 30 years, shrinkage in radiotherapy treatment areas and radiotherapy dose reductions are evaluated comparatively, taking into account historical processes. Methods: The demographic and clinical characteristics of the patients whose treatment was completed in the radiotherapy clinic of Ankara Numune Hospital between 1985-1990 will be summarized and the current imaging methods and treatment approaches at that time are compared with current approaches. Results: The data of 60 cases treated with the diagnosis of Hodgkin lymphoma in Ankara Numune Hospital between 1985-1990 are analyzed. The median age was 31. Histologic types and stages are distributed evenly between the groups. The initial involvement areas are such that; 34 cases start in the cervical-supraclavicular region (56%), eight in inguinofemoral (13%), seven in axillary (11%), five in mediastinal (8.2), three in the abdominal (5.3%), two in the tonsillar (3%), one in primary cerebral. Diseases that initiated under the diaphragm were 18% of the total. Mixcellular type constituted the most common group. In the 1980s, the standard treatment method for Stage IA and II A Hodgkin lymphoma was Sub Total Lymphoid Irradiation (Mantle, Inverted Y). In this period, the most advanced technique used in Hodgkin lymphoma imaging was Bi-Pedal Lymphangygraphy, while FDG PET-CT is the primary imaging method today. In this study, the number of recurrent patients is to be found 6 out of 58 who received radiotherapy. Four of them were outside the field, and two were within. Discussion and conclusion: The excessive number of out of field recurrences, side effects such as growth and development retardation, cardiac problems, and increase in secondary cancers caused (especially in the childhood age group) by wide-field radiotherapy applications; led researchers to seek new treatment modalities. Nowadays, applications of radiotherapy with reduced size and decreased dose combined with better chemotherapy practices. While improvements in both chemotherapy and radiotherapy techniques have increased the 5-year life above 90%, morbid side effects have remained anecdotal in historical articles

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Cetindag M (2021). Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. , 115 - 127. 10.5505/aot.2021.82473
Chicago	Cetindag Mehmet Faik Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. (2021): 115 - 127. 10.5505/aot.2021.82473
MLA	Cetindag Mehmet Faik Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. , 2021, ss.115 - 127. 10.5505/aot.2021.82473
AMA	Cetindag M Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. . 2021; 115 - 127. 10.5505/aot.2021.82473
Vancouver	Cetindag M Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. . 2021; 115 - 127. 10.5505/aot.2021.82473
IEEE	Cetindag M "Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti." , ss.115 - 127, 2021. 10.5505/aot.2021.82473
ISNAD	Cetindag, Mehmet Faik. "Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti". (2021), 115-127. https://doi.org/10.5505/aot.2021.82473

APA	Cetindag M (2021). Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. ACTA ONCOLOGICA TURCICA, 54(1), 115 - 127. 10.5505/aot.2021.82473
Chicago	Cetindag Mehmet Faik Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. ACTA ONCOLOGICA TURCICA 54, no.1 (2021): 115 - 127. 10.5505/aot.2021.82473
MLA	Cetindag Mehmet Faik Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. ACTA ONCOLOGICA TURCICA, vol.54, no.1, 2021, ss.115 - 127. 10.5505/aot.2021.82473
AMA	Cetindag M Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. ACTA ONCOLOGICA TURCICA. 2021; 54(1): 115 - 127. 10.5505/aot.2021.82473
Vancouver	Cetindag M Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti. ACTA ONCOLOGICA TURCICA. 2021; 54(1): 115 - 127. 10.5505/aot.2021.82473
IEEE	Cetindag M "Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti." ACTA ONCOLOGICA TURCICA, 54, ss.115 - 127, 2021. 10.5505/aot.2021.82473
ISNAD	Cetindag, Mehmet Faik. "Hodgkin Lenfoma Tedavisi; Son 30 Yılda Neler Değişti". ACTA ONCOLOGICA TURCICA 54/1 (2021), 115-127. https://doi.org/10.5505/aot.2021.82473