NCCN临床实践指南_霍奇金淋巴瘤(2019.V2)英文版

Version 2 2019 07 15 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Clinical Practice Guidelines in Oncology NCCN Guidelines Hodgkin Lymphoma Version 2 2019 July 15 2019 Continue NCCN org NCCN Guidelines for Patients available at www nccn org patients NCCN Guidelines Version 2 2019 Hodgkin Lymphoma Version 2 2019 07 15 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN NCCN Guidelines Index Table of Contents Discussion Richard T Hoppe MD Chair Stanford Cancer Institute Ranjana H Advani MD Vice Chair Stanford Cancer Institute Weiyun Z Ai MD PhD UCSF Helen Diller Family Comprehensive Cancer Center Richard F Ambinder MD PhD The Sidney Kimmel Comprehensive Cancer Center at John Hopkins Philippe Armand MD PhD Dana Farber Brigham and Women s Cancer Center Celeste M Bello MD MSPH Moffitt Cancer Center Cecil M Benitez PhD Stanford Cancer Institute Philip J Bierman MD x Fred 132 1013 1021 HODG 5 Stanford V algorithm has been removed Algorithms added for Deauville 4 5 following primary therapy with ABVD x 2 cycles and interim restaging Following additional therapy for deauville 4 after restaging if deauville 1 3 or deauville 4 5 with negative biopsy Options added ABVD x 2 cycles total 6 ISRT Option revised Escalated BEACOPP x 2 cycles ISRT For deauville 5 after primary therapy If biopsy negative option revised Escalated BEACOPP x 2 cycles ISRT Following additional therapy with escalated BEACOPP after restaging if deauville 1 3 or deauville 4 5 if biopsy negative the following option has been revised Escalated BEACOPP x 2 cycles ISRT Footnote cc added Escalated BEACOPP is only an option for those aged 10 cm adenopathy ABVD x 2 cycles category 1 has been listed as the preferred regimen Stanford V has been listed as an other recommended regimen Escalated BEACOPP has been moved to footnote ll and the subsequent algorithm page former HODG 9 has been removed Other recommended regimens if GHSG HD14 unfavorable see HODG A Escalated BEACOPP x 2 cycles ABVD x 2 cycles 30 Gy ISRT von Tresckow B et al J Clin Oncol 2012 30 907 913 Patients with B symptoms in combination with bulky or extranodal disease were excluded and treated according to the algorithm for stage III IV disease HODG 10 After ABVD x 2 and restaging Deauville 3 now follows the same pathway as deauville 1 2 Deauville 4 the preference has been removed for the following options ABVD x 2 cycles total 4 preferred for Deauville 3 or escalated BEACOPP x 2 cycles preferred for Deauville 4 Deauville 5 the following option has been added Escalated BEACOPP x 2 cycles followed by consider PET CT and ISRT 30 Gy HODG 9 Primary therapy for stage III IV CHL Stanford V option has been removed including the subsequent algorithm page former HODG 11 The following regimens have been revised and listed as useful in certain circumstances Escalated BEACOPPs x 6 2 cycles ISRT in selected patients if IPS 4 age 60 with Stage I II unfavorable CHL Stage III IV CHL Friedberg JW Forero Torres A Bordoni RE et al Frontline brentuximab vedotin in combination with dacarbazine or bendamustine in patients aged 60 years with HL Blood 2017 130 2829 2837 Friedberg JW Forero Torres A Holkova B et al Long term follow up of brentuximab vedotin dacarbazine as first line therapy in elderly patients with Hodgkin lymphoma abstract J Clin Oncol 2018 36 Suppl 15 Abstract 7542 Printed by Maria Chen on 7 24 2019 11 55 00 PM For personal use only Not approved for distribution Copyright 2019 National Comprehensive Cancer Network Inc All Rights Reserved NCCN Guidelines Version 2 2019 Hodgkin Lymphoma Version 2 2019 07 15 19 2019 National Comprehensive Cancer Network NCCN All rights reserved NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN Note All recommendations are category 2A unless otherwise indicated Clinical Trials NCCN believes that the best management of any patient with cancer is in a clinical trial Participation in clinical trials is especially encouraged NCCN Guidelines Index Table of Contents Discussion HODG 1 DIAGNOSIS WORKUPCLINICAL PRESENTATION Excisional biopsy recommended Core needle biopsy may be adequate if diagnostica Immunohisto chemistry evaluationb Essential H drenching night sweats or weight loss 10 of body weight within 6 mo of diagnosis alcohol intolerance pruritus fatigue performance status examination of lymphoid regions spleen liver CBC differential platelets Erythrocyte sedimentation rate ESR Comprehensive metabolic panel lactate dehydrogenase LDH and liver function test LFT Pregnancy test for women of childbearing age Diagnostic CTc contrast enhanced PET CT scand skull base to mid thigh or vertex to feet in selected cases Counseling Fer