在这项多中心合作中，我们报道了迄今为止最大的关于晚期复发/难治性霍奇金淋巴瘤（HL）患者使用围手术期放疗（pt-RT）和高剂量化疗自体干细胞移植（ASCT）长期疗效的真实世界数据系列。 我们进行了回顾性分析，包括12个机构的数据。符合条件的要求为：HL的组织学诊断；在2004-2014年之间接受了ASCT和pt-RT治疗难治性HL；在ASCT时年龄≥18岁。 所有患者在进行ASCT前都接受了最大程度的排瘤化疗。代谢反应根据Lugano分类进行评分。主要终点为总生存率（OS）。 采用单因素和多因素（MVA）Cox比例风险模型来估计协变量对患者疗效的影响。共有131名患者符合条件：68名（52％）为男性，ASCT时的中位年龄为32岁（范围为18-70岁）。 在难治性HL诊断时，92名（70％）患者有有限（I-II期）疾病，10名（8％）患者患有肿块性疾病。 在32名患者（24％）中，在ASCT前进行了Pt-RT治疗，而在99名患者（76％）中，在ASCT后进行了Pt-RT治疗。 中位预订剂量为30.6 Gy（范围为20-44 Gy）。 随访中位数为60个月，3年和5年的OS分别为84％和77％，而3年和5年的PFS分别为75％和72％。 在MVA中，复发期间的晚期疾病（HR为2.18，P = 0.04），放疗超过3个部位（HR为3.69，P = 0.01）以及排瘤化疗后的不完全代谢反应（HR为2.24，P = 0.01）对OS有负面影响。 Pt-RT的顺序（术前vs术后）不会影响结果。 总体而言，pt-RT对于难治性HL患者的ASCT具有非常好的疗效。 复发疾病有限并涉及不超过3个部位，并在排瘤化疗后达成完全代谢反应的患者的预后更有利。 版权所有©2023 Elsevier Inc. 发布。

In this multicenter collaboration, we report real-world data in the largest published series of long-term outcomes for patients with relapsed/refractory (r/r) Hodgkin lymphoma (HL) treated with peri-transplant radiotherapy (pt-RT) and high-dose chemotherapy with autologous stem cell transplant (ASCT).We conducted a retrospective analysis, including data from 12 institutions. Eligibility required histological diagnosis of HL, receipt of ASCT plus pt-RT between 2004-2014 for r/r HL, and age ≥18 years at time of ASCT. All patients received salvage chemotherapy for maximum debulking prior to ASCT. Metabolic responses were scored according to the Lugano Classification. The primary endpoint was overall survival (OS). Univariate and Multivariate (MVA) Cox proportional hazards were calculated to estimate the effect of covariates on patients' outcome.131 patients were eligible: 68 (52%) were male, median age at ASCT was 32 (range, 18-70) years. At time of diagnosis with r/r HL, 92 (70%) patients had limited (stage I-II) disease, and 10 (8%) patients had bulky disease. Pt-RT was given pre-ASCT in 32 patients (24%) and post-ASCT in 99 (76%); median prescribed dose was 30.6 Gy (range, 20-44 Gy). With median follow-up of 60 months, 3- and 5-year OS were 84% and 77%, while 3- and 5-year PFS were 75% and 72%, respectively. On MVA, advanced stage at relapse (HR 2.18, p=0.04), irradiation of >3 sites (HR 3.69, p=0.01), and incomplete metabolic response after salvage chemotherapy (HR 2.24, p=0.01) had a negative impact on OS. The sequencing of pt-RT (pre- vs post-ASCT) did not affect outcome.Overall, the addition of pt-RT to ASCT for patients with r/r HL is associated with very good outcomes. Limited relapsed disease with ≤3 sites involved, and achievement of complete metabolic response after salvage chemotherapy, were predictive of more favorable prognosis.Copyright © 2023. Published by Elsevier Inc.