gpoh-hd 2002

GPOH-HD 2002

hojkinis limfomis

optimizirebuli

Terapiis oqmi bavSvTa asakSi

1

oqmis saxeli

hojkinis limfomis mkurnalobis optimizirebuli sqema bavSvTa asakSi

Semoklebuli saxeli

GPOH-HD 2002

Cveneba

hojkinis limfoma bavSvTa asakSi ( 0 ndash 18w)

oqmis mizani

maRali dozis qimioTerapiis da misgan gamomdinare mogvianebiTi garTulebebis Tavidan acileba pirveladi daavadebis da recidivis mkurnalobis dros

oqmis pirveladi kiTxvebi

1SesaZlebelia Tu ara Terapiis pirveli jgufis pacientebs romlebic kompleqsur remisiaSi arian qimioTerapiis dasrulebis Semdeg sxivuri Terapiis ar Catarebis SemTxvevaSi ar gauaresdeT EFS

2 SesaZlebelia Tu ara Terapiis meore da mesame jgufis pacientebSi COPP-ciklSi prokarbazini Seicvalos dakarbaciniT ise rom ar gauaresdes EFS

3riskTan da Terapiis pasuxze adaptirebuli samkurnalo oqmis Sedegebis aRwera recidivis mkurnalobisas

oqmis meoradi kiTxvebi

1 SesaZlebelia Tu ara OEPA-ciklSi etopozidis dozis 20-iT gazrda da amiT adre arsebuli gansxvavebis gauqmeba biWebis da gogonebis samkurnalo sqemebSi

2 SesaZlebelia Tu ara COPP-ciklSi prokarbazinis Secvla dakarbaziniT arsebuli toqsikuri gverdiTi movlenebis pirobebSi

3rogori zemoqmedeba aqvs DHAP-s recidivis mkurnalobis dros IEP-ABVD-sTan SedarebiT

4mosalodnelia Tu ara pozitiuri Sedegi arasasurveli prognozis maCvenebeli maRali dozis qimioTerapiis Catarebis win autologiuri Rerovani ujredebis gadanergviT

2

mkurnaloba

meore da mesame jgufSi randomizirebuli mkurnaloba recidivis optimizirebuli mkurnaloba

samkurnalo populaciebi

bull Aaranamkurnalebi 18-wlamde asakis pacientebi klasikuri hojkinis limfomiT

bull pacientebi asakiT SezRudvis gareSe romlebsac ganuviTardaT pirveladi an meoradi recidivi hojkinis limfomis mkurnalobis Semdeg

pacientebis raodenoba

1200 pacienti Semdegi TanafardobiT jgufebis mixedviT 362836

Terapia

bull yvela pacients diagnozis dasmis Semdeg utardeba ori cikli OEPA(biWebSi) an ori cikli OPPA(gogonebSi) Amis Semdeg Terapiis pirvel jgufSi mkurnalobis Sedegebis mixedviT mkurnaloba an mTavrdeba an grZeldeba sxivuri TerapiiT

bull Terapiis meore da mesame jgufis pacientebi ki iReben COPP-is an COPDIC-is 2 an 4 kurss Semdeg ki sxivur Terapias

bull recidivis mqone pacientebis mkurnaloba xdeba riskTan da Terapiis pasuxze adaptirebuli sqemis mixedviT

samkurnalo oqmis pirveladi mizani

Terapiis ZiriTadi ganmsazRvreli kriteriumia daavadebisagan uSemTxvevo gadarCena (EFS- Event Free Survival)

samkurnalo oqmis saboloo mizani

1mTliani gamojamrTeleba (OS) 2daavadebis progresisagan Tavisufali periodi (PFS) 3Terapiis elementebis toqsiurobis xarisxi (CTC) 4mogvianebiTi Sedegebi

drois monakveTi

dasawyisi 2002 xangrZlivoba 2010 wlamde weliwadSi 180-dan 200 pacientamde mkurnalobis damTavrebidan minimaluri meTvalyureobis dro 5 welia gansazRvruli SeZlebisdagvarad yoveli pacienti mTeli sicocxlis manZilze unda iqnes meTvalyureobis qveS

3

protokolis dizaini gogonebisTvis

TG 1IABIIA

TG 2IEABIIEA

IIBIIIA

TG 3IIEBIIIEABIIIBIVAB

2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP

sruli remisia - dasxiveba ara

Aarasruli remisia -dasxiveba

Ppirveladi velebisdasxiveba

TG ndash Terapiuli Gjgufi B - B simptomebi A - B simptomebis ar arseboba

protokolis dizaini biWebisaTvis

4

1 5 9 13 17 21 kvira

TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC





3 cvlilebebi GPOH-HD95-Tan SedarebiT

5

1 5 9 13 17 21 kvira

I yvela pacientisTvis 1limfocitebiT predominanturi hojkinis limfomis mkurnaloba am sqemiT ar xdeba

2reducirebuli radioTerapia 50-100ml simsivnuri masis dros 2 kursi qimioTerapiis Semdeg(20Gy-nacvlad 35Gy)

3paraaortaluri limfuri jirkvlebis dazianebis SemTxvevaSi elenTis dasxiveba ar xdeba

4radioTerapiis maqsimaluri Semcireba (30Gy-nacvlad 35Gy-sa)

5standartizebuli riskTan da Terapiis efeqturobasTan adaptirebuli recidivis Terapis yvela im pacientisaTvis romelTac ganuviTardaT pirveladi an meoradi recidivi

6 CT-bazirebuli 3D konformaluri sxivuri Terapia

II yvela biWisaTvis etopozidis 5-micema nacvlad 4-sa

OEPA-s ciklSi

III pirveli Terapiuli jg pacientebi kompleqsuri remisiiT ar iReben radioTerapias

IV II da III Terapiuli jg 1randomizacia yvela pacientisaTvis

COPDIC- COPP-is winaaRmdeg 2pirveli ori qimioTerapiuli ciklis

Semdeg radioTerapiis dozis myari gansazRvra

3 radioTerapia yvepacientisTvis romlebic kompleqsur rearian

Tu ra cvlilebebi ganicada hojkinis limfomis samkurnalo gegmam HD-78-dan HD2002-mde mocemulia tabula 1(abg)-Si

6

tabula 1 Terapiuli oqmis modifikacia HD 78 ndashdan GPOH-HD 2003-mde

a) Terapiuli jgufi 1

oqmi stadia qimioTeraia radioTerapia

HD-78 ΙΙΙ A 2xOPPA 36-40GGy vrceli velis

DAL-HD 82

ΙΙΙ A 2xOPPA 35GGy pirveladi dazianebis velis

DAL-HD 85

ΙΙΙ A 2xOPA 35GGy

DAL-HD 87


narCeni simsivnis dros35Gy

DAL-HD 90

ΙΙΙ A gogonebi 2xOPPAbiWebi2x OEPA

25GGy


GPOH-HD95

ΙΙΙ A gogonebi 2xOPPAbiWebi 2x OEPA

remisia radioTerapia ar tardeba

remisi ara- 20GGy


GPOH-HD 2002



remisi ara 20GGy narCeni simsivnis dros3035Gy

lowastEtoposidi-s gadidebuli doza

b) Terapiuli jgufi 2

7

oqmi Stadia qimioTeraia radioTerapia

HD-78 gtΙΙA 2xOPPA4xCOPP

36-40GGy

DAL-HD 82

ΙIBIIIA 2xOPPA 2xCOPP

30GGy


DAL-HD 85

ΙIBIIIA 2xOPA2xCOMP

30GGy


DAL-HD 87

ΙIBIIIA 2xOPA 2xCOPP

25 Gy


DAL-HD 90

IniIIB IIniAIIIA

gogonebi 2xOPPA 2xCOPPbiWebi 2x OEPA 2xCOPP

25 Gy GnarCeni simsivnis dros3035Gy

GPOH-HD95

ΙniIIBΙΙniAIIIA

gogonebi 2xOPPA2xCOPPbiWebi 2xOEPA2xCOPP

remisia- radioTerapia ar tardeba

arasruli remisia-20Gy


GPOH-HD 2002 Pilot

ΙniIIBΙΙniAIIIA

gogonebi 2xOPPA2xCOPP biWebi 2xOEPPA2xCOPDIC

yvela 20Gy


8

g) Terapiuli jgufi 3oqmi Stadia qimioTeraia radioTerapia

HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82

ΙIIBIV 2xOPPA 2xCOPP

25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87

ΙIIBIV 2xOPA 2xCOPP

25GGy


DAL-HD 90

IIniBIIIBIIIniAIV

gogonebi 2xOPPA 2xCOPPbiWebi2x OEPA 2xCOPP

20GGy


GPOH-HD95

IIniBIIIBIIIniAIV

gogonebi 2xOPPA2xCOPPbiWebi2xOEPA 2xCOPP

20Gy

narCeni simsivnis drosmax30Gy

GPOH-HD 2002

IIniBIIIBIIIniAIV

gogonebi 2xOPPA2xCOPP biWebi 2xOElowastPA2xCOPDIC

yvela 20Gy


cvlilebebi radioTerapiaSi

9

wina samkurnalo sqemebTan SedarebiT GPOH-HD 2002-Si radioTerapiam ganicada Semdegi cvlilebebi GPOH-HD95-is monacemebma aCvenesrom Mmeore da mesame Terapiuli jgufis pacientebSiromlebsac radioTerapia ar miuRiaTsakmaod maRalia recidivis ganviTarebis riski bolo 2003wlis gamoTvlebze dayrdnobiT DSF-i Mmeore da mesame Terapiuli jgufis pacientebSi radioTerapiiT 92-s aRwevs maSin roca igive monacemebiT pacientebSi-komleqsuri remisiiT magram radioTerapiis gareSe DSF-78(Doumlrffel et al2003)aqedan gamomdinare aucilebelia Mmeore da mesame Terapiuli jgufis pacientebs- kompleqsuri remisiiT CautardeT radioTerapia

cvlilebebi invaziur diagnostikaSi

uari eTqva laparatomiasa da spleneqtomias invaziur diagnostikis aucileblobas saWiroa mxolod erTeul sadao SemTxvevaSi roca sonografiuli kompiuteruli magnitur-rezonansuli tomografiis gamokvlevis Sedegebis axsna gaZnelebulia dasaSvebia laparaskopia laparatomia ki mTlianad iqna uaryofili

specifiuri cvlilebebi meore da mesame biWebisTvis - prokarbazinis eliminaciaadre arsebulma gamokvlevebma aCvenes rom prokarbazini biWebSi unayofobis gamowvevia prokarbazinis kumulaciur dozasa da hormonalur darRvevas Soris arsebobs garkveuli urTierTdamokidebuleba ase magaliTad ori cikli OPPA-s Semdeg unayofoba SeiniSneboda 289 pacientebSi ori cikli OPPA-sa da ori cikli COPP-is Semdeg 438-Si ori cikli OPPA-sa da 4COPP-is Semdeg 625-Si maSasadame dozaze damokidebuli hormonuli darRvevebi asocirdeba permanentul unayofobasTan rac Seexeba qalebs qimioTerapia maT unayofobaze naklebad moqmedebs axalgazrda qalebSi arsebobs sakvercxis ukmarisobis da prematuruli menopauzis ganviTarebis garkveuli riski yovelive aqedan gamomdinare am samkurnalo sqemaSi aris mcdeloba prokarbazini Seicvalos sxva moqmedi substanciiT romelic ar gamoiwvevs unayofobisa da adreuli menopauzas hojkinis limfomis dros prokarbazini aris ara marto Zlier efeqturi preparati romelic pacientTa 38-Si kompleqsur remisias iwvevs aramed ixmareba rogorc monoTerapiuli saSualeba da agreTve kombinaciaSi TumcaRa samedicino gamocemebSi arsebuli informaciaze dayrdnobiT dakarbacini(DTIC) SeiZleba prokarbazinis Semcvleli iyosdakarbacinis moqmemedebis meqanizmi prokarbazinis msgavsia igi inhibirebas ukeTebs rogorc dnm-s ise rnm-sinTezs dakarbacini aris hojkinis limfomis dros aprobirebuli da daSvebuli preparati 6ABVD-ciklis Semdegac ar uviTardebaT mamrobiTi sqesis pacientebs rogorc wesi azospermia Pprokarbazinisgan gansxvavebiT DTIC-is aplikacia xdeba intravenurad 1972 wels dakarbacini aprobirebuli iqna rogorc moniTerapiuli saSualeba-250mgmsup2sup2sup2 doziT yovel dRe 5dRis manZilze samkviriani SualedebiT 56-Si miiRweoda bdquoobieqturildquo remisia Kleineri da doneri (1977w) mkurnalobdnen 10 pacients DTIC-is 300mgmsup2sup2doziT 5 erTmaneTze

10

miyolebuli dRe 4 kviriani SualediT 2 pacients ganuviTarda kompleqsuri remisiaxolo 7-s parcialuri maTi namuSevrebidan dadginda is faqti rom DTIC-s minimalur mielosupresiul zemoqmedeba axasiaTebs am da sxva monacemebze dayrdnobiT gamoangariSebul iqna eqvivalent-faqtori DTIC-Tvis daaxloebiT 24 ABVD-ciklSi gamoyenebuli 750mgmsup2 dakarbacini 1800mgmsup2sup2prokarbacins Seesabameba da mas SeuZlia COPP-ciklSi 1400mgmsup2sup2prokarbazini Secvalos am samkurnalo sqemaSi dakarbacini miiReba 250mgmsup2sup2doziT sami dRis manZilze 30 wuTis ganmavlobaSi intravenurad raTa SeZlebisdagvarad miRweul iqnas moqmedi maRali dozarac Seexeba qimioTerapiis toqsiur zemoqmedebis xarisxs GPOH-HD2002 Pilot-is monacemebze dayrdnobiT COPDIC-Terapiis dros maRali ar aris aRniSnuli gamosaxulia tab3

toqsiuroba

Sedegebis raodenoba cru Sedegi

0 Iordm IIordm IIIordm Vordm

zogadi mdgomareoba 4 11 44 3 0 0Hhemoglobini 0 15 31 14 2 0leikocitebi 0 37 19 5 1 0neitrofilebi 17 33 3 6 2 1Trombocitebi 0 58 4 0 0 0infeqcia 8 46 3 4 1 0temperatura 2 47 9 4 0 0gulisreva 4 47 11 0 0 0Rebineba 1 55 3 2 0 0stomatiti 1 54 6 1 0 0obstipacia 0 56 2 4 0 0diarea 0 60 1 1 0 0alergia 2 60 0 0 3 0tkivilebi 2 44 7 5 0 1sensoruli neirotoqsiuroba

5 42 14 1 0 0

motoruli neirotoqsiuroba

6 44 12 0 0 0

centraluri neirotoqsiuroba

3 59 0 0 0 0

kardiotoqsiuroba 49 13 0 0 0 0kreatinini 1 56 2 3 0 0proteinuria 14 45 3 0 0 0hematuria 12 50 0 0 0 0

kreatininis klirensi 34 26 2 0 0 0

es monacemebi naTlad cxadyofs rom COPDIC- bloki da DTIC pacientebSi naklebad toqsiur gverdiT movlenebs iwvevensamkurnalo sqemaSi miRebis kriteriumebi da pirveladi Terapia

miRebis kriteriumebi

11

yvela pacientebi 18 wlamde asakis hojkinis limfomis diagnoziT yvela isini unda akmayofilebdnen Semdeg pirobebs1hojkinis limfomis diagnozi

2asaki diagnozis dasmisas lt18 welze

3klinikis axsna-ganmarteba unda axldes Tan

4mSoblispacientis werilobiTi dasturi am samkurnalo sqemaSi monawileobaze

am samkurnalo sqemaSi ar CaerTvebianroca pacients aqvs

1zemgrZnobeloba an ukuCveneba medikamentebis mimarT

2nodularuli paragranulomis diagnozi

3sxva Terapiul sqemaSi ukve gawevrianebulia

4qimio- an radioTerapia Catarebuli aqvs

5aReniSneba sxva simsivnuri daavadeba

6orsuloba an ZuZuTi wovis periodi

7mZime TandarTuli daavadeba (magimunodefeqti)

8cnobili aiv-infeqcia

9pacientis an mSoblebis Tanxmobis ar arseboba

Ddiagnostika

12

1 histologiuri diagnozi

hojkinis limfomaze daeWvebis dros rac SeiZleba swrafad unda Catardes biopsia histologiuri diagnozis dasma xdeba limfuri jirkvlis biopsiis an pirveladad dazianebuli organos biopsiis Sedegad am dros unda iqnes mTliani limfuri jirkvali an didi nawili qsovilisa amoRebuliadgilze paTologebis mier diagnozis dadasturebis SeTxvevaSi gamokvleuli masala srulad igzavneba referens -laboratoriaSi

2klinikuri da laboratoriuli diagnostika

Aanamnezis Segroveba -adre arsebulian Tanmxlebi daavadebis Sesaxeb(nefrozuli sindromi da sxva autoimunuri daavadebebi) -zogadi simptomatika (B-simptomebi bolo 6Tvis manZilze wonis dakleba 10-ze meti persistirebadi ucnobi etiologiis temperatura Tanmxlebi oflianobiT Rame) - Catarebuli mkurnaloba

klinikuri gamokvleva - yvela im limfuri kvanZebis registrireba romelic isinjeba da regionis miTiTeba - RviZlis da elenTis palpacia (ramdeni santimetriT scildeba nekTa rkals) - yel-yur-cxviris eqimTan gamokvleva

laboratoriuli kvlevebi -sisxlis klinikuri suraTi sruli eds alati asati gamaglutamattransferaza tute fosfataza kreatinini albumini LDH -serologiuri kvleva Semdeg antisxeulebze VZV EBV CMV HSV HIV toqsoplazma da ABC hepatitebi instrumentuli gamokvlevebi

-gulmkerdis rendgenografia-muclis Rrus sonografia -eleqtrokardiografia -exokardiografia -encefalografia

danarCeni diagnostikuri zomebi(iseTi rogoricaa ekg filtvebis funqciis kvleva da aS) tardeba individualurad pacientis mdgomareobis mixedviT

13

inicialuri stadirebisaTvis gansazRvruli radiologiuri kvlevebi

kisris valdeieris rgolis laviwzeda da laviwqeda iRliis sazardulis muxlqveSa limfuri kvanZebis Sreobrivi kompiuteruli tomografia an magnitur resonansuli tomografia

muclis da mcire menjis Rrus Sreobrivi kompiuteruli tomografia an magnitur resonansuli tomografia

gulmkerdis kompiuteruli tomografia

ConCxis scintigrafia es ukanaskneli aucilebeli Catardes maSinac roca klinikurad pacients aReniSneba Zvlis tkivili

Zvlis biopsiaZvlis biopsia ori adgilidan ukeTdeba yvela im pacients romelTac aqvT gtIIA stadia

seleqtiuri laparaskopiawina samkurnalo oqmis-GPOH-HD95 monacemebze dayrdnobiT laparatomia winamdebare sqemaSi aRar gamoiyeneba Zalzed iSviaT SemTxvevebSi roca yvela arsebuli gamokvlevebi ar iZleva axsnas tardeba seleqtiuri laparaskopia igi gamoiyeneba gansakuTrebiT maSin roca saeWvoa gogonebSi iliakaluri limfuri jirkvlebis dazianebaovaropeqsiamaSin roca eWvgareSea iliakaluri limfuri jirkvlebis dazianeba tardeba operacia ovaropexsia erTi sakvercxis fiqsireba ureTrusis ukan kaudalurad roca erT mxarezea limfuri jirkvlebi CaTreuli da orive sakvercxis roca dazianeba ormxriviaAaucilebelia es operacia Catardes infradiafragmaluri dasxivebamde

fakultaturi gamokvlevebimamrobiTi sqesis pacientebSi aucilebelia nayofierebaze gamokvlevis Catareba da spermis konservireba qimioTerapiis dawyebamde

miRebuli Sedegebis Sefaseba

14

limfuri jirkvlebis Sefaseba

rogorc damoukidebeli limfuri jirkvlebis regionebi iTvlebian

1 sasis rkalis limfuri qsovilebi (marjvena da marcxena cal-calke)

2 cervikalurad (marjvena da marcxena cal-calke) bull kisris zeda bull kisris qveda

3 supraklavikularulad (marjvena da marcxena cal-calke)4 infraklavikularulad (marjvena da marcxena cal-calke)5 aqsilarulad (marjvena da marcxena cal-calke)6 filtvebis hilusi (marjvena da marcxena cal-calke) bronqo-

pulmonaluri limfuri jirkvlebi7 mediastinumis limfjirkvlebi

bull zeda nawili bifurkaciamdebull SuaSi hilusi subkarinalur regionamdebull qveda nawili diafragmamde

8 supradiafragmalurad9 elenTa10 elenTis hilusi11 RviZlis hilusi12 mezenterialurad mezenteriumi da mezokoloni13 paraaortalurad14 iliakalurad (marjvena da marcxena cal-calke)15 inguinalurad (marjvena da marcxena cal-calke)

Tu limfuri jirkvalis diametri 1sm-ze naklebia igi ar CaiTvleba simsivnurad dazianebulad

Tu limfuri jirkvalis diametri 2sm-ze metia igi CaiTvleba rogorc simsivnurad dazianebuli

Tu limfuri jirkvalis diametri 1sm-dan 2sm-mdea erTerT regionSi aseTi regioni CaiTvleba

eqstranodaluri dazianebebis Sefaseba

plevra da perikardiplevris simsivnuri dazianeba CaiTvleba Semdeg SemTxvevebSi roca limfoma aramkveTrad cximovani firfitis gareSe plevris pirdapir SemoisazRvreba an limfoma gulmkerdis kedelzea gamozneqili an limfoma gulmkerdis kedelSia infiltrirebuli an aris plevraluri eqsudati romelic ar aixsneba venuri SegubebiT

15

perikardiumis simsivnuri dazianeba CaiTvleba Semdeg SemTxvevebSi roca limfoma kontaqtSia gulis zedapirTan sarqvelebis sibrtyeze an aris perikaris eqsudati

organoTa dazianeba

organoTa dazianebaze maSin saubroben roca simsivnuri limfuri jirkvlebi romelime organoSi arian infiltrirebuli

filtvebidiseminirebul filtvebis dazianebaze da meoTxe stadiaze saubroben roca samze meti simsivnuri qsovilebis grovaa an intrapulmonaluri grovis diametri 8mm-s aRemateba

RviZli da elenTa RviZlis dazianeba yovelTvis meoTxe stadiaa marto elenTis dazianeba periferiuli limfuri kvanZebis dazianebis gareSe niSnavs pirvel stadias elenTisa da RviZlis mxolod zomebSi momateba ar miuTiTebs maT simsivnur procesSi CaTrevaze RviZlsa da elenTaSi grovis formis msgavsisimsivneze saeWvo struqturuli cvlileba iTvleba rogorc organos dazianeba

Zvlisa da Zvlis tvinis dazianebaZvlisa da Zvlis tvinis dazianebazea saubari maSin roca scintigrafiis Sedegad iqna naxuli erTidaigive ZvalzeZvlis tvinze simsivnuri grovebi es raTqmaunda CaiTvleba Zvlisa da Zvlis tvinis dazianebad da ganisazRvreba rogorc meoTxe stadia Uufro dawvrilebiTi lokalizaciis dasadgenad gamoiyeneba kompiuteruli da magnitur-rezonansuli tomografi Tu Zvlis biopsiis Sedegad naxuli iqna simsivnuri ujredebi es ueWvel dazianebasa da meoTxe stadiaze miuTiTebs

stadiis gansazRvra

16

I stadia roca dazianebuli erTaderTi limfuri jirkvlis regioni (I) an dazianebulia erTaderTi eqstra limfaturi organo an regioni (IE)

II stadia roca dazianebulia 2 an meti limfuri jirkvlebis regionebi diafragmis erTidaigive mxareze (II) an lokalurad dazianebulia eqstralimfaturi organo Tavisi regionaluri limfuri jirkvlebiT diafragmis erTidaigive mxareze (IIE)

III stadia roca dazianebulia limfuri jirkvlebi diafragmis orive mxares (III) romelsac SeiZleba Tan axldes elenTis dazianebac(IIIS) daan lokalurad eqstralimfaturi organoebis an qsovilebis (IIIE) an orTave erTdroulad (IIIES)

IV stadia roca adgili aqvs disseminirebul eqstralimfaturi organoTa dazianebas romelsac SeiZleba Tan axldes an ar axldes limfuri jirkvlebis dazianebac an izolirebulad erTi eqstralimfaturi organos dazianeba araregionaluri limfuri jirkvlebis procesSi CaTreviT

Y yoveli stadia A da B kategoriad aris dayofili

A zogadi simptomebis ar arseboba

B araumcires erT-erTi qvemoT moyvanili zogadi simptomebidan

a) bolo 6Tvis manZilze umizezod wonaSi kleba 10-ze metad

b) auxsneli persistirebadi temperatura 38ordmC

g) Zlieri oflianoba RamiT

Terapiul jgufebad dayofa

17

pacientebi onkokonferenciaze studiencentralSi Semdeg Terapiul jgufebad iyofian

pirveli Terapiuli jgufi (TG-1)

pacientebi romlebsac aqvT stadia I AB da IIA

meore Terapiuli jgufi (TG-2)

pacientebi romlebsac aqvT stadia I EAB IIEA IIB an IIIA

mesame Terapiuli jgufi (TG-3)

pacientebi romlebsac aqvT stadia IIEB IIIEAB IIIB an IVAB

Terapiis stratificireba da dawyeba

18

Terapiis droulad Catareba Zalzed mniSvnelovania iSviaT SemTxvevebSi-laparaskopiis aucileblobis dros operaciidan me-5 dRes unda iqnes dawyebuli qimioTerapiayoveli qimioTerapiis ciklebi daiwyeba im SemTxvevaSi Tu pacienti akmayofilebs Semdeg kriteriumebs

a zogadi mdgomareoba damakmayofilebelib leikocitebis raodenoba gt2000mmsup3c granulocitebis raodenoba gt500mmsup3d Trombocitebis raodenoba gt80000mmsup3e medikamentebis mimarT ukuCvenebis ar arseboba

raime gansakuTrebuloba OEPA-s OPPA-s COPP-sa da COPDIC-is dawyebis win saWiro ar aris vinaidan rogorc gamocdilebam aCvena mkveTrad gamoxatuli toqsiuri gverdiTi movlenebi ar aris mosalodneli iseTi interkurentuli daavadebebis arsebobisas rogoricaa sicxe 385ordmC-ze meti pnevmonia sepsisze eWvi varicela zosteri da sxva msgavsi qimioTerapiia unda Sewydes

TG-1yvela pacienti TG-1_dan gogonebi-2blok OPPA-s da biWebi-2 blok OEPA ndashs iReben qimioTerapiis Semdeg maT uterdebaT restadireba postTerapiul kompiuterul tomografiasa da magnitur rezonansul tomografiiT Tu progresi ar SeiniSneba maSin es pacientebi iyofian or samkurnalo qvejgufad

- pirveli qvejgufi moicavs yvela im pacients romelTac qimioTerapiis damTavrebis Semdeg pirveladad dazianebul regionebSi CTMRT-kriteriumebiT ganuviTardaT kompleqsuri remisia isini ar iReben radioTerapias

- qvejgufi B moicavs yvela im pacients romelTac qimioTerapiis damTavrebis Semdeg CTMRT-kriteriumebiT kompleqsur remisiaSi ar arian Rebuloben radioTerapias

pirveli jgufis pacientebisTvis dasxiveba qimioTerapiis damTavrebidan araugvianes 35-e dRes unda Catardes misi dasrulebas mosdevs Follow-up

TG-2 da TG-3

meore da mesame Terapiuli jgufis yvela pacienti gogonebi kvlav -2blok OPPA-s da biWebi-2 blok OEPA ndashs iReben Semdeg ki Staging-onkikonferenciaze isini gadian randomizacias COPP-sa da COPDIC-s Soris meore Terapiuli jgufis pacientebi iReben or cikls xolo mesame jgufis oTx ciklsyvela pacienti iRebs radioTerapias Mmanmade ki tardeba Restaging radioTerapia unda qimioTerapiis meoTxe an meeqvse ciklis Semdeg 25-e dRes daiwyos

941 OEPA OPPA

19

citostatikuri medikamentebis aplikaciis saxe da dozireba mocemulia sqemebSi ixqvemoTpirveli ciklis Semdeg modis me-16 dRidan 28-e dRemde Sesveneba rasac mohyveba Semdgomi cikli

OEPA-sqema

Prednisoloni 60mgm2 po gayofili sam miRebazedRe1 - 15 Etoposid 125mgm2 iv 2saaTSidRe 3-7

+ + + + +

Vincristin 15mgm2 iv maqs 2mgdRe 1+8=15

+ + +

Adriamicyn 100mgm2infuzia 4saaTSidRe 1+15

+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema

Prednisoloni 60mgm2 pogayofili sam miRebazedRe1 - 15 Procarbazin 100mgm2po 2-3 miRebaze dRe 1 ndash 15 Vincristin 15mgm2 iv maqs 2mgdRe 1+8 +15

+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20

meore Terapiul jgufis mkurnalobis sqemaSi OEPA OPPA-ciklebs emateba ori COPP an COPDIC-cikli xolo mesame Terapiul jgufis pacientebs utardebaT oTxi COPP an COPDIC-cikli yoveli ciklis Semdeg me-16 dRidan 28-e dRis CaTvliT aris Sesvenebacitostatikuri medikamentebis aplikaciis saxe da dozireba mocemulia Sesabamis sqemebSiciklofosfamidis yoveli micemisas aucilebelia uroproteqtor-mesnas micema dakarbacinis emetogenuri efeqtis Sesamcireblad ki naCvenebia 5-HT3-antagonistis an deqsametazonis an romelime neuroleptikis daniSvna

COPP-sqema Prednisoloni 40mgm2 pogayofili sam miRebazedRe 1 - 15 Procarbazin 100mgm2 po 2-3 miRebazedRe 1 - 15Vincristin 15mgm2 iv maqs 2mgdRe 1+8

+ +

Cyclofosfamidi 500mgm2ivinfuzia 60wTmesna 150mgm2 0saaTzemesna 500mgm2 24 sTSi+1500mlm2 NaCl09+1500mlm2 Gluc51+8 dRe

+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema

Prednisoloni 40mgm2 pogayofili sam miRebaze1 - 15 dReDcarbazin 250mgkg ivinfuzia 30wTdRe 1 - 3

+ + +

Vincristin 15mgm2 iv maqs 2mgdRe 1+8

+ +

Cyclofosfamidi 500mgm2iv infuzia 60wTmesna 150mgm2 0saaTzemesna 500mgm2 24 sTSi+1500mlm2 NaCl09+1500mlm2 Gluc51+8 dRe

+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

dozis modifikacia da kontracefcia

am samkurnalo sqemaSi mocemuli qimioTerapiuli saSualebebs kargad itanen pacientebi da amdenad dozis modificireba ar aris saWiro im erTeul SemTxvevebSi roca saxezea medikamentebis gamo gamowveuli mkveTrad gamoxatuli arasasurveli gverdiTi movlenebi unda moxdes alternatiuli saSualebis gamoZebna studiis xelmZRvanelobasTan erTadQqimio an radioTerapiis dros da maT Semdeg erTi wlis manZilze pacientebma unda moeridon bavSvis Casaxvas vinaidan drois am monakveTSi mavnebeli zemoqmedeba qimio da radioTerapiisa jer kidev mosalodnelia Kkontracefciuli saSualebebis Sesaxeb gadawyvetilebas eqimi iRebs individualurad TiToeul SemTxvevaSi

qimioTerapiis gverdiTi movlenebi

22

qimioTerapiis zogadi gverdiTi movlenebia gulisrevaRebineba wonaSi kleba Tmis cvena da meoradi simsivnis ganviTarebis riski

etopozidietopozidis mwvave gverdiTi movlenebi SeiZleba iyos alergiuli reaqciebi mukoziti periferiuli neiropaTiebi cns-toqsiuroba msubuqi Zvlis tvinis depresia etopozidiT inducirebuli meoradi leikozis ganviTarebis vada SeiZleba iyos ramodenime Tvidan wlamde FAB-klasifikaciiT M4M5 morfologiiT da 11q23-translokaciiT Tumca leikozis es forma dRemde ar dafiqsirebula

dakarbacinidakarbacini iwvevs Zlier gulisrevas da Rebinebas iSviaTad diareas gripis msgavs simptomebs alergiul egzanTemas kanze sicxes da fotosensibilizacias SesaZlebelia adgilobrivad ineqciis adgilze venebis gaRizianeba gamoiwvios misi Zvlis tvinze toqsiuri zemoqmedeba sustia iSviaTia aseve RviZlze Tirkmelebze da cns-ze misi mavne gavlena gansakuTrebiT mniSvnelovania aRiniSnos rom is ABVD-TerapiiT ar iwvevs permanentul azospermias aseve iSviaTia meoradi leikozis ganviTarebis SemTxvevebic

vinkristinivinkristinis mwvave gverdiTi movlenebia periferiuli neiropaTia obstipacia iSviaTad ewaraadeqvaturi ADH-sekreciis sindromi mkveTrad gamoxatuli periferiuli neiropaTiis dros romelsac axlavs siarulis darRvevac vinkristini SeiZleba Seicvalos vinblastinis 6mgmsup2ndashdoziT

ciklofosfamidiciklofosfamidis Sedegad SeiZleba ganviTardes Zvlis tvinis depresia hemoragiuli cistiti da maRalia infeqciebisadmi midrekileba

adriamiciniadriamicinis zemoqmedebiT SesaZlebelia ganviTardes gulis kunTis funqciis darRveva gulze mogvianebiTi garTulebebis Sesaxeb qimioTerapiis dasrulebis Semdeg informacia jerjerobiT ar aris qimioTerapiis dawyebamde aucilebelia eqokardiografiis Catareba gulis dazianebis SemTxvevaSi saWiroa alternatiuli Terapiuli saSualebis moZebna studiis xelmZRvanelobasTan erTad

prednizoloni rogorc leikoziani pacientebze dakvirvebebma aCvena rom prednizoloni iwvevs osteonekrozebs da SesaZlebelia xelovnuri saxsris aucileblobac Seiqnes garda aRniSnulisa SeiZleba ganviTardes Sesupeba wonaSi momateba maRalia infeqciebisadmi midrekileba da fsiqiuri cvlilebebis ganviTareba

23

prokarbazini prokarbazinis Sedegad SeiZleba ganviTardes gulisreva interstinaluri pnevmonia cns garTulebebi(neirotoqsiuri) alergiuli reaqciebi gonadebis dazianeba da Seuqcevadi azospermia

24

Terapiis warmatebis gansazRvra restadirebiT

Restadireba

pirveli restadireba yvela pacientisaTvis tardeba 2cikli qimioTerapiis Semdeg Restaging-i2cikli qimioTerapiis Semdeg yvela dazianebuli adgili xelaxla unda daTvalierdesCTMRT gamokvlevebi-qimioTerapiis damTavrebidan me-10 dRidan me14-dRis ganmavlobaSi unda Catardes yvela pacients me-14dRes utardeba FDG-PET gamokvleva pirveli Terapiuli jgufis pacientebis monacemebi igzavneba centrSi raTa ganisazRvros Semdgomi moqmedebani meore da mesame Terapiuli jgufis pacientebis agrZeleben Terapias is pacientebi romlebsac SeeniSnebaT daavadebis progresi gadian srul kompleqsur xelaxal gamokvlevas da Sedegebis mixedviT gadawydeba mkurnalobis Semdegi taqtika meore restadireba4cikli qimioTerapiis Semdeg meore meore Terapiuli jgufis pacientebSi Yyvela dazianebuli adgilebi eqvemdebarebian kvlevas CTMRT da eqografia unda Catardes bolo qimioTerapiuli ciklis miRebidan me-10 me-14 dRis vadebSi am jgufis pacientebs ewyebaT agreTve radioTerapia progresis SemTxvevaSi ki aucilebelia yvela limfuri jirkvlisakomleqsuri gamokvlevamesame restadireba6cikli qimioTerapiis Semdeg mesame Terapiuli jgufis pacientebSi Yyvela dazianebuli adgilebi eqvemdebarebian kvlevas CTMRT da eqografia unda Catardes bolo qimioTerapiuli ciklis miRebidan me-10 me-14 dRis vadebSi am jgufis pacientebs ewyebaT agreTve radioTerapia progresis SemTxvevaSi ki aucilebelia komleqsuri gamokvleva yvela limfuri jirkvlisa

nebismieri restadirebis dros Terapiis warmatebis gansazRvra Semdegi kriteriumebis mixedviT xorcieldeba

kompleqsuri remisia(CR)

Terapiis Sedegi rogorc kompleqsuri remisia fasdeba im SemTxvevaSi rocabull daavadebis yvela simptomi gamqralia da bull ar aris axali limfuri Tu eqstralimfuri regionebi dazianebuli dabull yvela nacnobi limfomregionebisTvis- pirveladi simsivnuri masis 95-ze meti ukuganviTarebulia- narCeni masa naklebia 2ml-ze

25

daudgeneli kompleqsuri remisia

Terapiis Sedegi rogorc kompleqsuri remisia-daudgeneli fasdeba im SemTxvevaSi rocabull ar aris kompleqsuri remisia da bull daavadebis yvela simptomi gamqralia da bull ar aris axali limfuri Tu eqstralimfuri regionebi dazianebuli dabull yvela nacnobi limfomregionebisTvis

- pirveladi simsivnuri masis 75-ze meti magram 95 naklebi ukuganviTarebulia an

- narCeni masa naklebia 2ml-ze

parcialuri remisia

Terapiis Sedegi rogorc parcialuri remisia fasdeba im SemTxvevaSi rocabull ar aris kompleqsuri remisia an daudgeneli kompleqsuri remisiabull ar SeiniSneba daavadebis progresirecidivTerapiis Cveneba aris mxolod imSemTxvevaSi roca damtkicebuli progresi an recidivia saxeze

progresi recidivi

daavadebis progresia rocabull daavadebis simptomebis xelaxali an sruliad axali auxsneli gamoCena anbull axali limfuri an eqstarlimfaturi regionebis gaCena an bull araumcires erTi limfomregionis simsivnuri masis mateba 25-ze metad da () bull vitaluri limfomujredebis aRmoCena zrdaSi myof an axlad aRmocenebul regionebSi

daavadebis progresi recidivi qviabullTerapiis dasrulebidan (qimioTerapiis bolo dRe prednizolonis CaTvliT an sxivuri Terapiis bolo dRe) sam TveSi ganviTarebuli procesi- progresibull Terapiis dasrulebidan sami Tvidan Tormet Tvemde ganviTarebuli- adreuli recidivibull Terapiis dasrulebidan Tormet Tvis Semdeg ganviTarebuli- mogvianebiTi recidivi

26

sxivuri Terapia

Cvenebebi da dozireba

1 pacientebs romlenic ganekuTvnebian pirvel Terapiul jgufs sruli remissiis SemTxvevaSi ar sxivdebian

2 pacientebi romlebic ganekuTvnebian pirvel Terapiul jgufs arasruli remissiis SemTxvevaSi sxivdebian doziT 20 grei

3 pacientebs romlenic ganekuTvnebian meore da mesame Terapiul jgufs sruli remissiis SemTxvevaSi sxivdebian doziT 20 grei

4 yvela pacienti romelTa narCeni masa sawyisTan SedarebiT 25 metia anu 75 isev rCeba sxivdebian doziT 30 grei

5 yvela pacienti romelTa narCeni masa 100 ml ia sxivdebian dosiT35 grei

6 eqstralimfuri organoebi Zvlis tvinis gamoklebiT eqvemdebarebian sxivur TerapiasdoziT 12 ndash 15 grei

7 sxivuri Terapia tardeba fraqciulad da dRiuri doza aris 18 grei gaminaklis warmoadgens filtvebi da am SemTxvevaSi dRiuri doza ar und aRematebodes 1-12 greis

8 recidivis SemTxvevaSi sayuradReboa pirveladi doza da ganmeorebiTi Terapiis sumaruli doza ar unda aRematebodes 40 greis

sxivuri Terapiis dawyeba

bolo qimioterapiuli reJimis damTavrebidan 3 kviris Semdeg

sxivuri Terapiis principebi

sxivuri Terapia pirveladi dagegmarebiT kompiuteruli simulaciiT da sxivuri aqseleratoris gamoyenebiT aris SesaZlebeli esYyovelive emsaxureba janmrTeli qsovilebis maqcimalur dacvas sxivebis mavne moqmedebisgan da samizne qsovilebis efeqtur dasxivebasTeqnikuri procesebis srul dacvaze pasuxismgebelia radioTerapevti

velebi

mkacrad aris gansazRvruli protokolis mixedviT da maqsimalurad moicavs mxolod inicialurad dazianebul limfur kvanZebs da eqstralimfur organoebs velebis SerCeva dagegmareba da pirobiTi sqemis Semoxazva xdeba radiologTa onkologTa da ratioTerapevTa erToblivi gadawyvetilebiT

27

helliphelliphelliphelliphelliphellip

28

valdeieris rgoli

kisris laviwzeda

laviwqveSaaqsilarulipeqtoruli

mediastinaluri

paraaortalurielenTis kariRviZlis kari

iliakaluri

sazardulisbarZayis

elenTa

limfuri kvanZebis regionebi

karis

mezenterialuri

Terapia im pacientebisTvis visTanac standartulma mkurnalobam ar uCvena efeqturoba da gamoixata daavadebis progresireba (Salvage Therapy)

mkurnaloba iwyeba kvlav qimioTerapiiT Ggamoiyeneba IEPABVD kursebi COPP da ChICEP reJimebTan erTad Pacientebis am jgufisTvis blokebis raodenoba winacwar ar aris mkacrad gansaxRvruli da damokidebulia pasuxze Tu pacients aReniSneba kargi pasuxi pirvel IEPABVD Terapiaze qimioTerapia sruldeba sxivuri TerapiiT cudi pasuxis SemTxvevaSi emateba COPP da ChICEP Terapia Semdgomi dasxivebiT

recidivis sawinaaRmdego Terapia

gamoiyofon recidivis or Tearapiul jgufs romlebic Tavis mxriv iyofa sam-sam qvejgufebad

1pirveli recidivi im pacientebSi vinc inicialurad miekuTvnebodnen pirvel Terapiul jgufs

bull pacientebi romelTac inicialurad ar Cautardad sxivuri Terapia unda miiRon IEP- ABVD- COPP-(IEP) + dazianebuli velebis dasxiveba doziT 25-30 grei

bull pacientebi romelbmac inicialurad miiRes dazianebuli velebis radioTerapia 20greiT da ganuviTrdad recidivi ukve dasxivebuli an axali velebis kombinaciiT IEP- ABVD- COPP-IEP + dasxiveba 20-25 grei dasxivebuli da 25-30 axali velebisaTvis

bull pacientebi romelTac ganuviTardaT ukve 20 greize meti doziT dasxivebuli an dausxivebeli regionebiT utrdebaT IEP- ABVD- COPP-IEP ndashABVD ndash COPP + sxivuri Terapia 10- 15 grei ukve dasxivebuli da 25-30 greiT dausxivebeli velebis

2pirveladi recidivi im pacientebSi vinc inicialurad miekuTvnebodnen meore da mesame Terapiul jgufebs

bull pacientebi romelTac ganuvitardad recidivi axali aradausxivebel regionebSi utardebaT IEP - ABVD - IEP ndashABVD ndash (IEP) + radioTerapia doziT 25-30grei

bull pacientebi romelTac ganuviTardaT ukve 20 greiT dasxivebuli an dausxivebeli regionebiT utrdebaT IEP- ABVD- IEP- ABVD - IEP + sxivuri Terapia 20-25 grei ukve dasxivebuli da 25-30 greiT dausxivebeli velebis

bull pacientebi romelTac ganuviTardaT ukve 20 greize meti doziT dasxivebuli an dausxivebeli regionebiT utrdebaT IEP- ABVD- -IEP ndashABVD ndash IEP + sxivuri Terapia 10- 15 grei ukve dasxivebuli da 25-30 greiT dausxivebeli velebis

recidivian pacientebs romelTac Terapiaze aReniSnebaT simsivnis neli an araefeqturi regresi SeZlebisdagvarad ezrdebaT sxivuri Terapiisdoza an Tu igi ar aris SeZlo ( sumaruli doza ar unda aRematebides 45

29

greis) sxivuri Terapiis Semdeg pacients eZleva ori damatebiTi qimioTerapiuli kursi ChICEP

antirecidiuli qimoTerapiis sqemebi

1Ifosfamidi 2000mgm2 24 saaTis ganmavlobaSi+mesna 1ndash5 dRe

2Etoposidi 125mgm2 iv 2 saaTis ganmavlobasi 1-5 dRe

3Prednisone 100mgm2Ppo sam miRebaze 1-5 dRe

1Adriamycin 25mgm2 iv 2saaTis ganmavlobasi 1+15 dRe

2Dacarbazin 375mgm2 iv 2saaTis ganmavlobasi 1+15 dRe

3bleomocyni 10mgm2 iv neli nakadiT 1+15 dRe

4Vinblastini 6mgm2 iv neli nkadiT 1+15 dRe

1CCNU 80mgm2 po 1 dRe

2Etoposid 100mgm2 po 1-5 dRe

3Prednison 40mgm2 po 1-5 dRe

4Chlorambuzil 6mgm2 po 1-5 dRe

30

IEP=IfosfamidEtoposidPrednison

ABVD=AdriamicynDacarbazinBleomycinVinblastin

ChICEP=CCNUEtoposidPrednisonChlorambuzil

pacientTa meTvalyureoba da kvlevebi mkurnalobis dasrulebis Semdeg

gamokvleva qimiodan 1kv-sSemdeg

Ddasxiv-dan 4kv-s Semdeg

1 welSi 2welSi 3welSi 4welSi

Aanamnezi times times Y yovel 6kviraSi yovel 3TveSi

yovel 6TveSi

sisxlis klanalizi times times Y yovel 3 TveSi yovel 6TveSi

times

muclis sonografia times times Y yovel 3 TveSi Yyovel 6 TveSi

CT MRT times times yovel3 TveSi yovel 3 TveSi

yovel 6TveSi

individualurad

CT-gulmkerdis times Yyovel3TveSi Yyovel 6TveSi

individualurad

Yyelis dasxivebis Semdeg farisjirksono da fT4 TSHTG

times 1 x weliwadSi

sakvercxis karcinomos skriningi(sono MRT)

25-wlidan qalebSi 1 x weliwadSi suprainfraklavikularuli regionis aqilaruli mediastinumis an filtvis dasxivebis Semdegs

Eekg eqokardiograf times times

LH-RH FSH prolaqtini testosteroni estradiolispermiograma

18wlis zemoT biWebSi 15 wlis zemoT gogonebSi

Llufu filtvebis an mediastinumis dasxivebis Semdeg

Terapiis dasrulebidan 1wlis Semdeg

times individua-lurad

times

radioTerapiis specialisti

times Terapiis dasrulebidan 1wlis Semdeg

1 x weliwadSi times

sicocxlis xarisxi Terapiis dasrulebidan 1wlis Semdeg

times

31

dokumentacia romelic unda warmoebdes da mkacrad unda iqnes daculi yvelaSemTxvevisaTvis

1 paTologis saboloo da oficialuri daskvnis originali2 yvela radiologiuri kvlevis daskvnis originali3 Terapiuli gegmis dizaini konkretuli pacientisTvis4 Terapiuli gegmebi TiToeuli qimioTerapiuli reJimisaTvis5 sxivuri Terapiis pirobiTi sqema pirveladi velebis moniSvniT6 dignozis stadirebis mkurnalobis da Semdgomi dakvirvebis midinareobisa

eqimis mier dawerili etapuri epikrizebi7 pacientis da misi meurvis Tanxmobis damadasturebeli specialuri werili

32

Terapiuli gegmis dizaini konkretuli gogona pacientisTvis

TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira

pacientis gvari saxeli ------------------------------------------------------------------------------------------

dabadebis TariRi ----------------------------------------------------------------------------------------------------

histologiuri diagnozi ----------------------------------------------------------------------------------------

stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------

Terapiuli gegmis dizaini konkretuli biWi pacientisTvis

TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira

pacientis gvari saxelihelliphellip__________________________________________

dabadebis TariRi -------------------------------------------------------------------------------------------

histologiuri diagnozi --------------------------------------------------------------------------------

stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------

saxeli ---------------------------- gvari ----------------------------------------------dabadTariRi -------------

wona -----------------------------kg simaRle -------------------------sm sxeulis farTi ---------------m2

prednizoloni 60mgm2 po gay 3 miRebaze

prokarbazini 100mgm2 po gay2-3 miRebaze

vinkristini 15mgm2 iv maqs2mg

adriamicini 40mgm2 iv infuzia 4sT

K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

saxeli ---------------------------- gvari ----------------------------------------------dabadTariRi ------------------





etopozidi 125mgm2 iv infuzia 2sT

36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA

saxeli ---------------------------- gvari ----------------------------------------------dabadTariRi --------

wona ----------------------kg simaRle -------------------------sm sxeulis farTi --------------- m2

prednizoloni 40mgm2 pogay 3 miRebaze

prokarbazini100mgm2 pogay2-3 miRebaze

vinkristini15mgm2 iv maqs2mg

ciclofosfamidi500mgm2 ivinfuzia 1sT

mesna 150mgm2 0sTmesna500mgm224 sT+1500mlm2 NaCl09+1500mlm2 Gluc5

K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=

saxeli ---------------------------- gvari ----------------------------------------------dabadTariRi ---------------



dakarbazini250mgm2 ivInfusia 30wT123 dRe



mesna 150mgm2 0sTmesna500mgm224sT+1500mlm2 NaCl09+1500mlm2 Gluc5

K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=

saxeli ---------------------------- gvari ----------------------------------------------dabadTariRi ----------

wona -----------------------kg simaRle -------------------------sm sxeulis farTi --------------- m2


ifosfamidi2000mgm2 ivmessna 700mgm2 0sTmesna 2000mgm2 24sT-Si2500ml siTxe 24sT-SiNaCl 09Cluc 5 +KCl 75 10ml500ml+laziqsi 10mg100ml

etopozidi125mgm2 ivinfuzia 2sTetopozidi iwyeba ifosfamidis dawyebi-dan 4sT is Semdegam dros ifosfamidi wydeba

K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=

saxeli ------------------------ gvari ------------------------------------------dabadTariRi ------------------


adriamicini25mgm2 ivInfuzia 2sT

dacarbazini375mgm2 iv Infuzia 2sT

bleomicini10mgm2 ivinfuzia nelinakadiT

vinblastini6mgm2 ivInfusia nelinakadiT

40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M


wona ------------------------kg simaRle -------------------------sm sxeulis farTi --------------- m2

ccnu 40mgm2 po

etapozidi100mgm2 po

prednizoloni40mgm2 pogay 3 miRebaze

qlorambucili6mgm2 pogay 3 miRebaze

41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP

saxeli ------------------------ gvari ---------------------------------------dabadTariRi ------------------

Catarebuli qimioTerapia-----------------------------------------------------------

sxivuri Terapiis doza---------------------------------------------------------------

42

K sxivuri Terapiis sqema

literatuara

Anagnostopoulos I Hansmann ML Franssila K Harris M Harris NL Jaffe ES Han J van

Krieken JM Poppema S Marafioti T Franklin J Sextro M Diehl V Stein H (2000) European

Task Force on Lymphoma project on lymphocyte predominance Hodgkin disease histological

and immunohistologic analysis of submitted cases reveals 2 types of Hodgkin disease with a

nodular growth pattern and abundant lymphocytes Blood 96 1889-1899

Apperley JF Reddy N (1995) Mechanisms and management of treatment-related gonadal failure

in chemoradiotherapy Blood 9 93 -116

Bumann D Beyer W Herbst K Clausen M Hossfeld DK (1997) Whole-body positron emission

tomography (PET) for diagnosis of residual mass in patients with lymphoma Ann Oncol 8 57-

60

Brink I Reinhardt MJ Hoegerle S Altehoefer C Moser E Nitzsche EU (2001) Increased

metabolic activity in the thymus gland studied with 18F-FDG PET age dependency and

frequency after chemotherapy J Nucl Med 42 591-595

Benenson L Wickenhauser C Starostik P Staratschek-Jox A Muumlller-Hermelink HK Diehl V

Wolf J (2002) Proficient mismatch repair protein expression in Hodgkin and Reed Sternberg

cells Int J Cancer 97 205-210

Bernardo MP Weller E Backstrand KH Silver B Marcus KC Tarbell NJ Friedberg J Canellos

GP Mauch PM (2002) Long-term survival and competing causes of death in patients with early-

stage Hodgkins disease treated at age 50 or younger J Clin Oncol 20 2101ndash2108

Bonadonna G Santoro A Gianni AM Viviani S Siena S Bregni M Zucali R Lombardi F

Bonfante V Gianni L (1991) Primary and salvage chemotherapy in advanced Hodgkinrsquos disease

the Milan Cancer Institute experience Ann Oncol 1 9ndash16

Bohlen H Kessler M Sextro M Diehl V Tesch H (2000) Poor clinical outcome of patients with

Hodgkins disease and elevated interleukin-10 serum levels Clinical significance of interleukin-

10 serum levels for Hodgkins disease Ann Hematol 79110-113

Buzaid AC Lippman SM Miller TP (1987) Salvage therapy of advanced Hodgkinrsquos disease

Critical appraisal of curative potential Am J Med 83 523ndash532

43

Baetz T Belch A Couban S Imrie K Yau J Myers R Ding K Paul N Shepherd L Iglesias J

Meyer R Crump M (2003) Gemcitabine dexamethasone and cisplatin is an active and non-toxic

chemotherapy regimen in relapsed or refractory Hodgkins disease a phase II study by the

National Cancer Institute of Canada Clinical Trials Group Ann Oncol 141762-1767

Cline MJ Berlin N (1963) Anemia in Hodgkinrsquos disease Cancer 16526-532

Carde P Koscielny S Franklin J Axdorph U Raemaekers J Diehl V Aleman B Brosteanu O

Hasenclever D Oberlin O Bonvin N Bjorkholm M (2002) Early response to chemotherapy a

surrogate for final outcome of Hodgkins disease patients that should influence initial treatment

length and intensity Ann Oncol 13 86-91

Carbone PP Kaplan HS Musshoff K Smithers DW Tubiana M (1971) Report of the

Committee on Hodgkins disease Staging Classification Cancer Res 31 1860-1861

Gajewski JL Phillips GL Sobocinski KA Armitage JO Gale RP Champlin RE Herzig RH

Hurd DD Jagannath S Klein JP Lazarus HM McCarthy PL Jr Pavlovsky S Peterson FB

Rowlings PA Russell JA Silver SM Vose JM Wiernik PH Bortin MM Horowitz MM (1996)

Bone marrow transplants from HLA-identical siblings in advanced Hodgkins disease J Clin

Oncol14 572-578

Claviez A Klingebiel T Beyer J Nurnberger W Ehninger G Suttorp M Dreger P Dorffel W

Schmitz N (2004) Allogeneic peripheral blood stem cell transplantation following fludrabine-

based conditioning in six children with advanced Hodgkinrsquos disease Ann Hematol 83 237-241

Dorffel W Luders H Ruhl U Albrecht M Marciniak H Parwaresch R Potter R Schellong G

Schwarze EW Wickmann L (2003) Preliminary results of the multicenter trial GPOH-HD 95 for

the treatment of Hodgkins disease in children and adolescents analysis and outlook Klin

Padiatr 215 139-145

Donaldson SS Link MP (1987) Combined modality treatment with low-dose radiation and

MOPP chemotherapy for children with Hodgkinrsquos disease J Clin Oncol 5 742- 749

Dieckmann K Potter R Hofmann J Heinzl H Wagner W Schellong G Pediatric Cooperative

Hodgkin Disease Study Group of the GPOH (2003) Does bulky disease at diagnosis influence

outcome in childhood Hodgkins disease and require higher radiation doses Results from the

44

German-Austrian Pediatric Multicenter Trial DAL-HD-90 Int J Radiat Oncol Biol Phys 56

644-652

Donaldson SS Kaplan HS (1982) Complications of treatment of Hodgkinrsquos disease in children

Cancer Treat Rep 66 977-989

Dobert N Pantel J Frolich L Hamscho N Menzel C Grunwald F (2004) Diagnostic value of

FDG-PET and HMPAO-SPET in patients with mild dementia and mild cognitive impairment

metabolic index and perfusion index Dement Geriatr Cogn Disord 20 63-70

Donaldson SS Link MP (1991) Hodgkinrsquos disease Treatment of the young child Pediatr Clin

North Am 38 457-473

Ferme C Mounier N Divine M Brice P Stamatoullas A Reman O Voillat L Jaubert J

Lederlin P Colin P Berger F Salles G (2002) Intensive salvage therapy with high-dose

chemotherapy for patients with advanced Hodgkinrsquos disease in relapse or failure after initial

chemotherapy results of the Groupe drsquoEtudes des Lymphomes de lrsquoAdulte H89 trial J Clin

Oncol 20 467ndash475

Grufferman SL Delzell E (1984) Epidemiology of Hodgkinrsquos disease Epidemiol 6 76

Green DM Gingell RL Pearce J Panahon AM Ghoorah J (1987) The effect of mediastinal

irradiation of cardiac function of patients treated during childhood and adolescence for

Hodgkinrsquos disease Clin Oncol 5239-245

Hancock SL Tucker MA Hoppe RT (1993) Factors affecting late mortality from heart disease

after treatment of Hodgkins disease JAMA 270 1949-1955

Harris NL Jaffe ES Diebold J Flandrin G Muller-Hermelink HK Vardiman J Lister TA

Bloomfield CD (1999) The World Health Organization classification of neoplastic diseases of

the hematopoietic and lymphoid tissues Report of the Clinical Advisory Committee meeting

Airlie House Virginia November 1997Ann Oncol 101419-1432

Hassel JU Braumlmswig JH Schlegel W Schelong G (1991) Testicular function after OPACOMP

chemotherapy without Procarbazin for boys and girls with Hodgkinrsquos disease Klin Paumldiat 203

268-272

45

Henry-Amar M Pellae-Cosset B Bayle-Weisgerber C Hayat M Cosset JM Carde P Tubiana

M (1989) Risk of secondary acute leukaemia and preleukamia after Hodgkinrsquos disease The

Institute Gustave-Roussy experience Rec Results canser Res 117 270-283

Hoh CK Glaspy J Rosen P Dahlbom M Lee SJ Kunkel L Hawkin RA Maddahi J Phelps ME

(1997) Whole-body FDG-PET imaging for staging of Hodgkins disease and lymphoma J Nucl

Med 38 343-348

Howell SJ Radford JA Adams JE Shalet SM (2000) The impact of mild Leydig cell

dysfunction following cytotoxic chemotherapy on bone mineral density (BMD) and body

composition Clin Endocrinol 52 609-616

Jerusalem G Beguin Y Fassotte MF Najjar F Paulus P Rigo P Fillet G (2001) Whole-body

positron emission tomography using 18F-fluorodeoxyglucose compared to standard procedures

for staging patients with Hodgkins disease Haematologica 86 266-273

Karapetis CS Strickland AH Yip D Walt JD Harper PG (2001) PET and PLAP in suspected

testicular cancer relapse Ann Oncol 121485-1488

Kupper M Joos S von Bonin F Daus H Pfreundschuh M Lichter P Trumper L (2001) MDM2

gene amplification and lack of p53 point mutations in Hodgkin and Reed-Sternberg cells results

from single-cell polymerase chain reaction and molecular cytogenetic studies Br J Haematol

1128-75

Kuppers R Schwering I Brauninger A Rajewsky K Hansmann ML (2002) Biology of

Hodgkins lymphoma Ann Oncol 13 11-18

Kuppers R Klein U Hansmann ML Rajewsky K (1999) Cellular origin of human B-cell

lymphomas N Engl J Med 3411520ndash1529

Lister TA Crowther D Sutcliffe SB Sutcliffe SBGlatstein E Canellos GP Young RC

Rosenberg SA Coltman CA Tubiana G (1989) Report of a committee convened to discuss the

evaluation and staging of patients with Hodgkins disease Cotswolds meeting J Clin Oncol 7

1630-1636

46

Le Deley MC Leblanc T Shamsaldin A Raquin MA Lacour B Sommelet D Chompret A

Cayuela JM Bayle C Bernheim A de Vathaire F Vassal G Hill C (2003) Risk of secondary

leukemia after a solid tumor in childhood according to the dose of epipodophyllotoxins and

anthracyclines a case-control study by the Socieacuteteacute Franccedilaise dOncologie Peacutediatrique J Clin

Oncol 21 1074-1081

Longo DL Duffey PL Young RC Hubbard SM Ihde DC Glatstein E Phares JC Jaffe ES

Urba WJ DeVita VT Jr (1992) Conventional-dose salvage combination chemotherapy in

patients relapsing with Hodgkinrsquos disease after combination chemotherapy the low probability

for cure J Clin Oncol 10 210 -218

Martin-Subero JI Gesk S Harder L Sonoki T Tucker PW Schlegelberger B Grote W Novo

FJ Calasanz MJ Hansmann ML Dyer MJ Siebert R (2002) Recurrent involvement of the REL

and BCL11A loci in classical Hodgkin lymphoma Blood 99 1474-1477

Meadows AT Obringer AC Marrero O Oberlin O Robison L Fossati-Bellani F Green D

Voute PA Morris-Jones P Greenberg M (1989) Second malignat neoplasms fillowing childhood

Hodgkinrsquos disease Med Prdiat Oncol 17 477-484

Milpied N Fielding AK Pearce RM Ernst P Goldstone AH (1996) Allogeneic bone marrow

transplant is not better than autologous transplant for patients with relapsed Hodgkins disease

European Group for Blood and Bone Marrow Transplantation J Clin Oncol 14 1291-1296

Nachman JB Sposto R Herzog P Gilchrist GS Wolden SL Thomson J Kadin ME Pattengale

P Davis PC Hutchinson RJ White K (2002) Randomized comparison of low-dose involved-

field radiotherapy and no radiotherapy for children with Hodgkins disease who achieve a

complete response to chemotherapy J Clin Oncol 18 3765-3771

Nadali G Tavecchia L Zanolin E Bonfante V Viviani S Camerini E Musto P Di Renzo N

Carotenuto M Chilosi M Krampera M Pizzolo G (1998) Serum level of the soluble form of the

CD30 molecule identifies patients with Hodgkins disease at high risk of unfavorable outcome

Blood 913011-3016

Partridge S Timothy A OrsquoDoherty MJ Hain SF Rankin S Mikhaeel G (2000) 2-fluorine-18-

fluoro-2-deoxy-D glucose positron emission tomography in the pretreatment staging of

Hodgkins disease influence on patient management in a single institution Ann Oncol 111273-

1279

47

Pileri SA Ascani S Leoncini L Sabattini E Zinzani PL Piccaluga PP Pileri A Jr Giunti M

Falini B Bolis GB Stein H (2002) Hodgkins lymphoma the pathologists viewpoint J Clin

Pathol 55 162-176

Rehwald U Schulz H Reiser M Sieber M Staak JO Morschhauser F Driessen C Rudiger T

Muller-Hermelink K Diehl V Engert A (2003) Treatment of relapsed CD20+ Hodgkin

lymphoma with the monoclonal antibody rituximab is effective and well tolerated results of a

phase 2 trial of the German Hodgkin Lymphoma Study Group Blood 101 420ndash424

Ruhl U Albrecht M Dieckmann K Luders H Marciniak H Schellenberg D Wickmann L

Dorffel W (2001) Response-adapted radiotherapy in the treatment of pediatric Hodgkins disease

an interim report at 5 years of the German GPOH-HD 95 trial Int J Radiat Oncol Biol Phys 51

1209-1218

Rigo P Paulus P Kaschten BJ Hustinx R Bury T Jerusalem G Benoit T Foidart-Willems J

(1996) Ontological applications of positron emission tomography with fluorine-18 fluorodeoxy-

glucose Eur J Nucl Med 231641

Phillips JK Spearing RL Davies JM Hay CR Parry H Nash JR Cawley JC (1990) VIM-D

salvage chemotherapy in Hodgkinrsquos disease Cancer Chemother Pharmacol 27161-163

Schellong G Poumltter R Braumlmswig J Wagner W Prott F Doumlrffel W Koumlrholz D Mann G

Rath B Reiter A Weissbach G Riepenhausen M Thiemann M Schwarze EW (1999) High

Cure rates and reduced long-term toxicity in paediatric Hodgkins disease The German-Austrian

Multicenter Trial DAL-HD-90 J Clin Oncol 17 3736-3744

Schellong G Hornig-Franz I Rath B Ritter J Riepenhausen M Kabisch H Goldschmitt-Wuttge

B Schmidt P Niethammer D Gaedicke G (1994) Reduzierung der Strahlendosen auf 20-30Gy

im Rahmen einer kombinierten ChemoRadiotherapie beim Morbus Hodgkin im Kindesalter-ein

Bericht der kooperativen Therapiestudie DAL-HD-87 Klin Paumldiat 206 253-263

Schellong G Doumlrffel W Claviez A Koumlrholz D Mann G Scheel-Walter H-G Boumlkkerink JPM

Riepenhausen M Luumlders H Poumltter R Ruumlhl U (2005) Salvage therapy of progressive and

recurrent Hodgkinrsquos disease Results from a multicenter study of the pediatric DALGPOH-HD

Study Group J Clin Oncol 23 6181-6189

48

Schelong G (1996) The balance between cure and late affects in childhood Hodgkinrsquos

Lymphoma The experience of the German-Austian-Study-Group since 1978 Annals of

Oncology 7 67-72

Schellong G Houmlrnig-Franz I (1993) Salvage therapy results in childhood Hodgkinrsquos disease In

Zander AR Barlogie B (eds) Autologous bone marrow transplantation for Hodgkinrsquos lymphoma

and multiple myeloma Springer Verlag BerlinHeidelberg Germany pp 8-10

Schwartz CL (2003) The management of Hodgkin disease in the young child Curr Opin Pediatr

15 10-16

Sklar C Whitton J Mertens A Stovall M Green D Marina N Greffe B Wolden S Robison L

(2000) Abnormalities of the thyroid in survivors of Hodgkins disease data from the Childhood

Cancer Survivor Study J Clin Endocrinol Metab 85 3227-3232

Schnell R Borchmann P Schulz H Engert A (2003) Current strategies of antibody-based

treatment in Hodgkinrsquos disease Ann Oncol 13 57ndash66

Shankar AG Ashley S Radford M Barrett A Wright D Pinkerton CR (1997) Does histology

influence outcome in childhood Hodgkins disease Results from the United Kingdom Childrens

Cancer Study Group J Clin Oncol1997 15 2622-2630

Stumpe KD Urbinelli M Steinert HC Glanzmann C Buck A Schulthess GK (1998) Whole-

body positron emission tomography using fluorodeoxyglucose for staging of lymphoma

effectiveness and comparison with computed tomography Eur J Nucl Med 25 721-28

Stein H Marafioti T Foss HD Laumen H Hummel M Anagnostopoulos I Wirth T Demel G

Falini B (2001) Down-regulation of BOB1OBF1 and Oct2 in classical Hodgkin disease but not

in lymphocyte predominant Hodgkin disease correlates with immunoglobulin transcription

Blood 97 496-501

Seitz V Hummel M Marafioti T Anagnostopoulos I Assaf C Stein H (2000) Detection of

clonal T-cell receptor gamma-chain gene-rearrangements in Reed-Sternberg cells of classic

Hodgkins disease Blood 95 3020ndash3024

Skinnider BF Mak TW (2002) The role of cytokines in classical Hodgkin lymphoma Blood

99 4283-97

49

Schmitz N Pfistner B Sextro M Sieber M Carella AM Haenel M Boissevain F Zschaber R

Muller P Kirchner H Lohri A Decker S Koch B Hasenclever D Goldstone AH Diehl

V(2002) Aggressive conventional chemotherapy compared with high-dose chemotherapy with

autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkinrsquos

disease a randomised trial Lancet 359 2065ndash2071

Vassilev LT Vu BT Graves B Carvajal D Podlaski F Filipovic Z Kong N Kammlott U

Lukacs C Klein C Fotouhi N Liu EA (2004) In vivo activation of the p53 pathway by small-

molecule antagonists of MDM2 Science 303 844 -848

Weiss LM Movahed LA Warnke RA Sklar J (1989) Detection of EBV genomes in Reed

Sternberg cells of Hodgkinrsquos disease J Clin Oncol 320 502-504

Wiedmann E Baican B Hertel A Baum RP Chow KU Knupp B Adams S Hor G Hoelzer D

Mitrou PS(1999) Positron emission tomography (PET) for staging and evaluation of response to

treatment in patients with Hodgkins disease Leuk Lymphoma 34 545-551

Wolden SL Lamborn KR Cleary SF Tate DJ Donaldson SS Wolden SL Lamborn KR Cleary

SF (1998) Second cancers following pediatric Hodgkins disease J Clin Oncol 16 536-544

Yuen AR Rosenberg SA Hoppe RT Halpern JD Horning SJ (1997) Comparison between

conventional salvage therapy and high-dose therapy with autografting for recurrent or refractory

Hodgkinrsquos disease Blood 89 814ndash22

Xiros N Binder T Anger B Bohlke J Heimpel H (1998) ITP in Hodgkinrsquos disease patients

Eur J Hematol 40 437-441

50

51

oqmis saxeli

hojkinis limfomis mkurnalobis optimizirebuli sqema bavSvTa asakSi

Semoklebuli saxeli

GPOH-HD 2002

Cveneba

hojkinis limfoma bavSvTa asakSi ( 0 ndash 18w)

oqmis mizani

maRali dozis qimioTerapiis da misgan gamomdinare mogvianebiTi garTulebebis Tavidan acileba pirveladi daavadebis da recidivis mkurnalobis dros

oqmis pirveladi kiTxvebi

1SesaZlebelia Tu ara Terapiis pirveli jgufis pacientebs romlebic kompleqsur remisiaSi arian qimioTerapiis dasrulebis Semdeg sxivuri Terapiis ar Catarebis SemTxvevaSi ar gauaresdeT EFS

2 SesaZlebelia Tu ara Terapiis meore da mesame jgufis pacientebSi COPP-ciklSi prokarbazini Seicvalos dakarbaciniT ise rom ar gauaresdes EFS

3riskTan da Terapiis pasuxze adaptirebuli samkurnalo oqmis Sedegebis aRwera recidivis mkurnalobisas

oqmis meoradi kiTxvebi

1 SesaZlebelia Tu ara OEPA-ciklSi etopozidis dozis 20-iT gazrda da amiT adre arsebuli gansxvavebis gauqmeba biWebis da gogonebis samkurnalo sqemebSi

2 SesaZlebelia Tu ara COPP-ciklSi prokarbazinis Secvla dakarbaziniT arsebuli toqsikuri gverdiTi movlenebis pirobebSi

3rogori zemoqmedeba aqvs DHAP-s recidivis mkurnalobis dros IEP-ABVD-sTan SedarebiT

4mosalodnelia Tu ara pozitiuri Sedegi arasasurveli prognozis maCvenebeli maRali dozis qimioTerapiis Catarebis win autologiuri Rerovani ujredebis gadanergviT

2

mkurnaloba







Terapia








drois monakveTi


3


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP






4

1 5 9 13 17 21 kvira

TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC






5

1 5 9 13 17 21 kvira








OEPA-s ciklSi







6





DAL-HD 82


DAL-HD 85


DAL-HD 87



DAL-HD 90


25GGy


GPOH-HD95



remisi ara- 20GGy


GPOH-HD 2002






7



36-40GGy

DAL-HD 82


30GGy


DAL-HD 85


30GGy


DAL-HD 87


25 Gy


DAL-HD 90

IniIIB IIniAIIIA



GPOH-HD95

ΙniIIBΙΙniAIIIA





GPOH-HD 2002 Pilot

ΙniIIBΙΙniAIIIA


yvela 20Gy


8


HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82


25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87


25GGy


DAL-HD 90

IIniBIIIBIIIniAIV


20GGy


GPOH-HD95

IIniBIIIBIIIniAIV


20Gy


GPOH-HD 2002

IIniBIIIBIIIniAIV


yvela 20Gy



9





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51

mkurnaloba







Terapia








drois monakveTi


3


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP






4

1 5 9 13 17 21 kvira

TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC






5

1 5 9 13 17 21 kvira








OEPA-s ciklSi







6





DAL-HD 82


DAL-HD 85


DAL-HD 87



DAL-HD 90


25GGy


GPOH-HD95



remisi ara- 20GGy


GPOH-HD 2002






7



36-40GGy

DAL-HD 82


30GGy


DAL-HD 85


30GGy


DAL-HD 87


25 Gy


DAL-HD 90

IniIIB IIniAIIIA



GPOH-HD95

ΙniIIBΙΙniAIIIA





GPOH-HD 2002 Pilot

ΙniIIBΙΙniAIIIA


yvela 20Gy


8


HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82


25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87


25GGy


DAL-HD 90

IIniBIIIBIIIniAIV


20GGy


GPOH-HD95

IIniBIIIBIIIniAIV


20Gy


GPOH-HD 2002

IIniBIIIBIIIniAIV


yvela 20Gy



9





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP






4

1 5 9 13 17 21 kvira

TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC






5

1 5 9 13 17 21 kvira








OEPA-s ciklSi







6





DAL-HD 82


DAL-HD 85


DAL-HD 87



DAL-HD 90


25GGy


GPOH-HD95



remisi ara- 20GGy


GPOH-HD 2002






7



36-40GGy

DAL-HD 82


30GGy


DAL-HD 85


30GGy


DAL-HD 87


25 Gy


DAL-HD 90

IniIIB IIniAIIIA



GPOH-HD95

ΙniIIBΙΙniAIIIA





GPOH-HD 2002 Pilot

ΙniIIBΙΙniAIIIA


yvela 20Gy


8


HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82


25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87


25GGy


DAL-HD 90

IIniBIIIBIIIniAIV


20GGy


GPOH-HD95

IIniBIIIBIIIniAIV


20Gy


GPOH-HD 2002

IIniBIIIBIIIniAIV


yvela 20Gy



9





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51

TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC






5

1 5 9 13 17 21 kvira








OEPA-s ciklSi







6





DAL-HD 82


DAL-HD 85


DAL-HD 87



DAL-HD 90


25GGy


GPOH-HD95



remisi ara- 20GGy


GPOH-HD 2002






7



36-40GGy

DAL-HD 82


30GGy


DAL-HD 85


30GGy


DAL-HD 87


25 Gy


DAL-HD 90

IniIIB IIniAIIIA



GPOH-HD95

ΙniIIBΙΙniAIIIA





GPOH-HD 2002 Pilot

ΙniIIBΙΙniAIIIA


yvela 20Gy


8


HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82


25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87


25GGy


DAL-HD 90

IIniBIIIBIIIniAIV


20GGy


GPOH-HD95

IIniBIIIBIIIniAIV


20Gy


GPOH-HD 2002

IIniBIIIBIIIniAIV


yvela 20Gy



9





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51








OEPA-s ciklSi







6





DAL-HD 82


DAL-HD 85


DAL-HD 87



DAL-HD 90


25GGy


GPOH-HD95



remisi ara- 20GGy


GPOH-HD 2002






7



36-40GGy

DAL-HD 82


30GGy


DAL-HD 85


30GGy


DAL-HD 87


25 Gy


DAL-HD 90

IniIIB IIniAIIIA



GPOH-HD95

ΙniIIBΙΙniAIIIA





GPOH-HD 2002 Pilot

ΙniIIBΙΙniAIIIA


yvela 20Gy


8


HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82


25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87


25GGy


DAL-HD 90

IIniBIIIBIIIniAIV


20GGy


GPOH-HD95

IIniBIIIBIIIniAIV


20Gy


GPOH-HD 2002

IIniBIIIBIIIniAIV


yvela 20Gy



9





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51





DAL-HD 82


DAL-HD 85


DAL-HD 87



DAL-HD 90


25GGy


GPOH-HD95



remisi ara- 20GGy


GPOH-HD 2002






7



36-40GGy

DAL-HD 82


30GGy


DAL-HD 85


30GGy


DAL-HD 87


25 Gy


DAL-HD 90

IniIIB IIniAIIIA



GPOH-HD95

ΙniIIBΙΙniAIIIA





GPOH-HD 2002 Pilot

ΙniIIBΙΙniAIIIA


yvela 20Gy


8


HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82


25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87


25GGy


DAL-HD 90

IIniBIIIBIIIniAIV


20GGy


GPOH-HD95

IIniBIIIBIIIniAIV


20Gy


GPOH-HD 2002

IIniBIIIBIIIniAIV


yvela 20Gy



9





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51



36-40GGy

DAL-HD 82


30GGy


DAL-HD 85


30GGy


DAL-HD 87


25 Gy


DAL-HD 90

IniIIB IIniAIIIA



GPOH-HD95

ΙniIIBΙΙniAIIIA





GPOH-HD 2002 Pilot

ΙniIIBΙΙniAIIIA


yvela 20Gy


8


HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82


25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87


25GGy


DAL-HD 90

IIniBIIIBIIIniAIV


20GGy


GPOH-HD95

IIniBIIIBIIIniAIV


20Gy


GPOH-HD 2002

IIniBIIIBIIIniAIV


yvela 20Gy



9





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


HD-78 rogorc jg-2

2xOPPA4xCOPP

36-40GGy

DAL-HD 82


25GGy


DAL-HD 85

ΙIIBIV 2xOPA2xCOMP

25GGy


DAL-HD 87


25GGy


DAL-HD 90

IIniBIIIBIIIniAIV


20GGy


GPOH-HD95

IIniBIIIBIIIniAIV


20Gy


GPOH-HD 2002

IIniBIIIBIIIniAIV


yvela 20Gy



9





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51





10


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


toqsiuroba




5 42 14 1 0 0


6 44 12 0 0 0


3 59 0 0 0 0





11















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51















Ddiagnostika

12









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51









13










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51










14














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51














15


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


organoTa dazianeba





stadiis gansazRvra

16












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51












17









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51









18








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51








TG-2 da TG-3


941 OEPA OPPA

19


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


OEPA-sqema


+ + + + +


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

OPPA-sqema


+ + +


+ +

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

642 COPP COPDIC

20



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51



+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

21

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51

COPDIC-sqema


+ + +


+ +


+

+

+

+

dReebi 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15




22








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51








23


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


24


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


Restadireba





25





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51





parcialuri remisia


progresi recidivi



26

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51

sxivuri Terapia














velebi


27


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


28

valdeieris rgoli

kisris laviwzeda


mediastinaluri


iliakaluri

sazardulisbarZayis

elenTa


karis

mezenterialuri














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51














29














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51














30









yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51






yovel 6TveSi


times



yovel 6TveSi

individualurad


individualurad


times 1 x weliwadSi









times



1 x weliwadSi times


times

31




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51




32


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOPPA

2xOPPA 2xCOPP

2xOPPA 4 x COPP




33

1 5 9 13 17 21 kvira




stadia ----------------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ---------------------------------------------------------------------------------------------------

dasxivebis doza ------------------------------------------------------------------------------------------------------


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


TG 1IABIIA

TG 2IEABIIEA

IIBIIIA


2xOEPA

2xOEPA 2xCOPDIC

2xOEPA 4 x COPDIC




34

1 5 9 13 17 21 kvira




stadia --------------------------------------------------------------------------------------------------------------

Terapiuli jgufi ________________________________________________

dasxivebis doza ----------------------------------------------------------------------------------------------







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51







K kursi OPPA

35

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51







36

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8M2 M5

K kursi OEPA








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51








K kursi COPP

37

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15M8

Mmg=

Mmg=

ml=








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51








K kursi COPDIC

38

Mmg=

Mmg=

Mmg=

Mmg=

MdRe

M1 M15M8

Mmg=

Mmg=

Mml=






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51






K kursi IEP

39

Mmg=

mg=

mg=

MdRe

M1 M3M2 M4 M5 M6 M7

mg=

ml

M mg=







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51







40

K kursi ABVD

Mmg=

Mmg=

Mmg=

Mmg=

MdReM1 M15

M



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51



ccnu 40mgm2 po

etapozidi100mgm2 po



41

M mg=

mg=

MdRe

M1 M3M2 M4 M5

Mmg=

Mmg=

K kursi ChICEP




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51




42


literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51

literatuara










60


















43
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51
















Oncol14 572-578







Padiatr 215 139-145






44


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51


644-652







North Am 38 457-473


















268-272

45






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51






Med 38 343-348












1128-75








1630-1636

46





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51





Oncol 21 1074-1081





















Blood 913011-3016




1279

47



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51



Pathol 55 162-176








1209-1218


















48



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51



Oncology 7 67-72





15 10-16















Blood 97 496-501





99 4283-97

49





















50

51





















50

51

gpoh-hd 2002

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