中线外周T细胞淋巴瘤的临床特点与治疗  

Clinical characteristics and treatment of midline peripheral T cell lymphoma

作　　者：顾仲义[1] 朱向帜[1] 李枫[1] 黄克伟[1] 

机构地区：[1]江苏省肿瘤医院放射治疗科

出　　处：《中华放射肿瘤学杂志》1999年第1期12-14,共3页Chinese Journal of Radiation Oncology

摘　　要：目的分析中线外周Ｔ细胞淋巴瘤（ＭＰＴＬ）的临床特点、预后及治疗。方法１９８１年１月至１９９３年６月收治ＭＰＴＬ１０９例。７３例作单纯放射治疗，３６例作放射治疗＋化疗或化疗＋放射治疗的综合治疗。化疗方案为ＣＣＮＵ（环己亚硝脲），ＣＯＭＰ（环磷酰胺，长春新碱，甲氨蝶呤，强的松）和ＣＨＯＰ（环磷酰胺，阿霉素，长春新碱，强的松）。鼻腔与副鼻窦病变的放射治疗以鼻前野为主，鼻咽、扁桃体病变均用面颈联合野。放射治疗剂量４０～６０Ｇｙ。结果总的５年生存率和１０年生存率分别为５５．０％和４１．９％。综合治疗组中用ＣＣＮＵ，ＣＯＭＰ和ＣＨＯＰ方案的５年生存率分别为４０．０％，３０．０％和７５．０％，单纯放射治疗组为５６．２％，后两者差异无显著意义。病变侵犯一个部位者生存率明显高于侵犯≥２个部位者（Ｐ＜０．００１）。有全身症状者生存率明显低于无发热盗汗者（Ｐ＜０．００１）。病变侵犯一个部位且无全身症状者５年生存率为７９．３％。局部邻近复发率为１８．３％，且有第２，３次邻近复发者。结论病变侵犯一个部位且无全身症状者可作单纯放射治疗。照射野要宽大，应包及病变可能扩展的范围。放射治疗剂量宜为５０～６０Ｇｙ。对病变累及≥２个部位且有全身?Objective To analyse the clinical characterstics of midline peripheral T cell lymphoma (MPTL) and evaluate its treatment.Methods From Jan. 1981 to Jun. 1993, 109 patients with MPTL were treated by radiation (RT) alone or radiotherapy plus chemotherapy or chemotherapy plus radiotherapy. For chemotherapy, CCNU, COMP (CTX,ADM,VCR,PDN) or CHOP (CTX,VCR,MTX,PDN) regimen was given. Radiation was given through anterior field of the nose mainly for nasal and paranasal sinus MPTL and through faciocervical field for MPTL of the Walderyer's ring. Total dose was 40～65 Gy in 4～7 weeks.Results The overall 5 year and 10 year survival rates were 55.0% and 41.9%, respectively. The 5 year survival rate was: RT group 56.2%, RT+CHOP or CHOP + RT group 75.0% (P>0.05), RT+CCNU group 40% and RT+COMP 30.0%. The 5 year survival rates of patients with one site involved and ≥ 2 sites involved were 75.0%(33/44) and 41.5%(27/65), respectively (P<0.001). The 5 year survival rates of patients with and without B symptoms were 39.1% (18/46) and 66.7% (42/63),(P<0.001). The 5 year survival rate of patients with one site involved and without B was 79.3%(23/28). The local regoinal recurrence rate was 18.3%(20/109) and 4 patients even developed recurrence for the second and third time. The distant metastasis rate of patients who died was 53.7%.Conclusions Radiotherapy alone should be the treatment of choice for patients with one site involvement and without B symptoms. Radiation fields should be large enough to include the potentially involved sites. The recommended dose is 50～60 Gy in 5～6 weeks. It is suggested that patients with ≥ 2 sites involvement and those with B symptoms should received combination therapy with CHOP regimen.

关 键 词：放射疗法 药物疗法 中线外周淋巴瘤 临床特点 

分 类 号：R733.4[医药卫生—肿瘤] R739.6[医药卫生—临床医学]