儿童头颈部非霍奇金淋巴瘤21例临床分析  

Clinical analysis of 21 children with non Hodgkin's lymphoma originated from head and neck

作　　者：李萍[1] 黄东生[1] 张谊[1] 张伟令[1] 梅妍妍[1] 韩涛[1] 周燕[1] 朱霞[1] 张品伟[1] 

机构地区：[1]首都医科大学附属北京同仁医院儿科,北京100176

出　　处：《中国小儿血液与肿瘤杂志》2014年第5期254-258,共5页Journal of China Pediatric Blood and Cancer

摘　　要：目的分析儿童头颈部非霍奇金淋巴瘤(NHL)的临床资料,探讨儿童的发病特点、诊断、治疗及预后。方法回顾性分析2005年5月-2013年5月我院儿科收治的21例经病理确诊的NHL患儿临床资料。男13例,女8例,中位年龄72个月。分析临床发病特点、疗效及预后。结果 (1)原发部位:头颈部结外淋巴组织19例,占90%,其中咽淋巴环及眼眶内各8例,分别占38%;原发于咽淋巴环8例患儿中,鼻咽部4例,扁桃体1例,会厌1例,咽旁间隙1例,上颚1例。(2)临床分期:Ⅱ期7例(33%),Ⅲ期6例(29%),Ⅳ期8例(38%)。(3)疗效及预后:21例患儿中19例规律治疗并获随访。中位化疗疗程11个疗程,首次治疗后化疗有效率95%,无效率5%。3年总生存率和无进展生存率分别是90%和80%。结论儿童头颈部NHL对化疗敏感,即使晚期行综合治疗仍具有较高的临床缓解率及生存期,但应注意起病特点增加确诊率。Objective We studied the clinical data of children with non Hodgkin＇ s lymphoma（NHL） originated from head and neck,investigated the clinical features,diagnosis,treatment and prognosis. Methods We retrospectively analyzed the clinical data in 21 pathologically confirmed cases of head and neck NHL between May 2005 and May 2013,including 13 males and 8 females,with a median age of 72 months. The clinical characteristics,clinical efficacy and prognosis were analyzed by statistical methods. Results（1） the primary site： extranodal accounted for 90%,of which Waldeyer ring and the orbit of 38% each,in children with the first episode in Waldeyer ring,nasopharyngeal involvement accounted for 50%.（2） clinical stage： Ⅱ 7 cases（33%）,III 6 cases（29%）,Ⅳ 8 cases（38%）.（3）the clinical efficacy and prognosis： the media chemotherapy was consisted of 11 courses,effective rate after the first stage of chemotherapy was 95%,and 5% with chemotherapy resistance. The 3-year overall survival（OS） and progression-free survival（PFS） were 90% and 80%,respectively. Conclusions Children with head and neck NHL,with a feature of sensitive to chemotherapy,have higher rate of clinical remission and survival even for patients in advanced stage after comprehensive therapy. More attention should be paid to the onset characteristics to improve the early diagnosis.

关 键 词：头颈部 非霍奇金淋巴瘤 儿童 预后 

分 类 号：R733.1[医药卫生—肿瘤]