Background/Objectives: The treatment of older patients with classic Hodgkin lymphoma (eHL) remains a challenge.Methods: This study reports the first real-life survey of eHL treated with contemporary therapies in Italy. One hundred and fifty eHL patients were treated between 2013 and 2018: seventy-one were aged 60–69 years and seventy-nine ≥70 years (median age 70.5 years; range = 60–89). Curative treatments included ABVD-like regimens and attenuated approaches alternating ABVD-like regimens with non-anthracycline-containing cycles.Results: After a median follow-up of 81 months, the 5-year overall survival (OS) was 87% for patients aged 60–69 and 62% for those aged ≥70. Among 132 patients (88%) treated with curative intent, the 5-year cancer-specific survival (CSS) was 93% for the 60–69 group and 70% for the ≥70 group, while event-free survival (EFS) was 78% and 58%, respectively (p< 0.001). Multivariate analysis showed that age ≥ 70, omission of radiotherapy (RT), and failure to achieve complete remission (CR) after chemotherapy were significant predictors of OS, CSS, and EFS. Synthetic data analysis confirmed that omitting RT worsens outcomes at all stages, while reduced-dose anthracycline regimens are non-inferior to full-dose schedules.Conclusions: This survey highlights key prognostic factors and supports the optimization of future treatment strategies including targeted drugs.
背景/目的：老年经典霍奇金淋巴瘤（cHL）患者的治疗仍具挑战性。方法：本研究首次报告了意大利采用当代疗法治疗cHL的真实世界调查。2013年至2018年间共治疗150例cHL患者：其中71例年龄60-69岁，79例≥70岁（中位年龄70.5岁；范围60-89岁）。根治性治疗方案包括ABVD类方案及减量化方案（交替使用ABVD类方案与不含蒽环类药物的化疗周期）。结果：中位随访81个月后，60-69岁患者5年总生存率（OS）为87%，≥70岁患者为62%。在132例（88%）接受根治性治疗的患者中，60-69岁组5年癌症特异性生存率（CSS）为93%，≥70岁组为70%；无事件生存率（EFS）分别为78%和58%（p<0.001）。多变量分析显示，年龄≥70岁、省略放疗（RT）以及化疗后未达完全缓解（CR）是OS、CSS和EFS的显著预测因子。综合数据分析证实，省略放疗会恶化各分期患者的预后，而减量蒽环类药物方案与全剂量方案相比具有非劣效性。结论：本调查明确了关键预后因素，为未来包含靶向药物的治疗策略优化提供了依据。
肿瘤(癌症)患者之家