髓外浆细胞瘤临床分析  

Treatment of extramedullary plasmacytoma

作　　者：王维虎[1] 李素艳[1] 高黎[1] 曲媛[1] 徐国镇[1] 李晔雄[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院放射治疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2004年第3期211-214,共4页Chinese Journal of Radiation Oncology

摘　　要：目的探讨髓外浆细胞瘤的生物学行为和临床特点,以帮助临床诊断、治疗及对预后的判断。方法对40多年来笔者所在科室收治的28例髓外浆细胞瘤进行回顾性分析,其中单纯放射治疗16例(57.1%),综合治疗11例(39.3%),单纯手术1例(3.6%)。结果中位随访90个月(4～280个月),2例(7.1%)局部复发,2例(7.1%)转化为多发性骨髓瘤。3、5、10年总生存率分别为92.6%、75.6%和75.6%;单纯放射治疗组与综合治疗组3、5、10年总生存率分别为93.8%、77.3%、77.3%和90.9%、72.7%、72.7%(P>0.05)。结论单纯放射治疗是治疗髓外浆细胞瘤最有效的方法之一,局部放射治疗DT40Gy～50Gy后,可获得良好的局部控制率和长期生存率。部分髓外浆细胞瘤可向多发性骨髓瘤转化,故需密切观察。Objective To analyze the clinical feature of extramedullary plasmacytoma (EMP) and treatment results. Methods From Jan. 1960 to Aug. 2000, 28 EMP patients accumulated in a period of 40 odd years were evaluated retrospectively. Sixteen of them were treated with radiotherapy alone (R group,57.1%) with a median dose of 50?Gy, 11 with combined modality therapy (CMT group,39.3%) and 1 with surgery alone (S group,3.6%). Results During a median follow up of 90 months (4 280 months), 2 developed local recurrence and 2 were converted to multiple myeloma. The overall 3 , 5 , and 10 year survival rates were 92.6%,75.6% and 75.6% ,respectively. In the R group, the overall 3 , 5 , and 10 year survival rates were 93.8%, 77.3% and 77.3%, as compared with 90.9%, 72.7% and 72.7% in the CMT group (P>0.05). Conclusions Extramedullary plasmacytoma may well be cured with small field and limited dose of radiation therapy alone. The diagnosis of extramedullary plasmacytoma requires a complete work up (including MRI) and strict criteria to exclude multiple myeloma. Close follow up is necessary in those converted to multiple myeloma.

关 键 词：髓外浆细胞瘤 放射治疗 多发性骨髓瘤 长期生存率 临床分析 综合治疗 单纯 结论 转化 帮助 

分 类 号：R730.4[医药卫生—肿瘤] R730.5[医药卫生—临床医学]