Aim. The observational program was aimed at obtaining data on classical Hodgkin's lymphoma (cHL) incidence in the Russian Federation, therapy options, and clinical outcomes of treatment. The aim of the prospective part of the program was to standardize the approaches to therapy and to compare its outcomes with off-protocol treatment. Materials & Methods. The prospective-retrospective observational program for Hodgkin's lymphoma treatment engaged 32 regional and federal centers. It included 218 patients, 21 out of them were included into the prospective part of the RNWOHG-HD1 (Russian North-West Oncology and Hematology Group - Hodgkin Disease Study 1) program. The median age was 36 years (range 22-87 years). cHL stages I/II were identified in 48 % of patients, III/IV stages were reported in 52 % of patients. The prospective part of the program used escalating protocol in patients with stages I/IIA and without risk factors and de-escalating protocol in patients with advanced stages. Overall (OS) and progression-free (PFS) survivals were analyzed in 160 and 152 patients, respectively. PET-CT was used to assess the response in 33 % of patients. Results. The study used the following first-line chemotherapy regimens: ABVD in 42 %, BEACOPPst in 11 %, BEACOPP-14 in 17 %, BEACOPPesc in 25 %, and EACOPP in 1 % of cases. After the completion of first-line therapy objective response rate was 91 % including 61 % of complete responses. Response structure did not significantly differ in the groups of non-intensive therapy (ABVD and BEACOPPst), intensified regimens (BEACOPP-14, BEACOPPesc, and EACOPP), and treatment according to the RNWOHG-HD1 protocol (91 %, 92 %, and 96 %, respectively; p = 0.7226). In the total cohort the 3-year OS was 97 % (95% confidence interval [95% CI] 94-99 %), PFS was 87 % (95% CI 80-92 %). The 3-year PFS did not differ in ABVD, BEACOPPst, BEACOPP-14, BEACOP-Pesc, and RNWOHG-HD1 recipients (р = 0.37). International Prognostic Score (IPS) yielded significant results in PFS prediction for patients with IPS score of 5-6, but not for those with IPS score of 1-4 (p = 0.0028). Conclusion. The observational program showed that the majority of participating centers use the risk-adapted ABVD/ BEACOPPesc approach which explains no difference in PFS being found with the use of these chemotherapy options. The study demonstrated the need for PET-CT to assess the response since the CT alone cannot distinguish between complete and partial responses in a considerable number of patients. The prospective unified program for cHL treatment may well be implemented in the Russian Federation.

The present study was undertaken to determine the diagnostic accuracy of positron emission tomography (PET) in the staging and restaging of malignant lymphomas. For determination of the extent of a neoplastic process, complex radiation examination was conducted in 67 patients with malignant lymphomas. In 12 (17.9%) cases, the stage of the disease was changed, as evidenced by PET. There is evidence that the technique is of high diagnostic accuracy in detecting malignancies of l ymph nodes, skeletal system, and parenchymatous organs in lymphoproliferative diseases.

Использование современных подходов к пространственному планированию лучевой терапии высокими энергиями позволяет достичь полного локального контроля при лечении злокачественных лимфом различных структур органа зрения в 100% случаев. Лимфомы кожи могут быть разной степени злокачественности и по-разному реагировать на цитостатики; часто полихимиотерапия недостаточно эффективна как при большой, так и при малой площади поражения кожи. Лучевая терапия быстрыми электронами с помощью линейных ускорителей электронов является наиболее эффективным, а иногда и единственным методом лечения. Однако существующие крупнопольные методы электронного облучения не дают удовлетворительных клинических результатов при тотальном кожном поражении. Способ облучения, разработанный в ЦНИРРИ (патент на изобретение №2185215 от 20.07.02) прошел успешные клинические испытания в отделении лучевой терапии системных заболеваний и лучевой патологии ЦНИРРИ у 6 больных с распространенными лимфомами кожи III и IV стадий после неэффективной полихимиотерапии. Во всех наблюдениях достигнут положительный результат в виде полной или частичной ремиссии после фракционированного электронного облучения по 2 Гр до суммарной дозы 35-44 Гр на кожу и опухолевые узлы, распространяющиеся в подкожную клетчатку.