成人朗格汉斯组织细胞增生症放射治疗的疗效合并文献复习  

Efficacy of Radiation Treatment for Adult Langerhans Histiocytosis and Review of the Literature

作　　者：张蓓蓓[1] 高春玲[1] 王笑良[1] 陈金平[1] 章志勇[1] 

机构地区：[1]厦门大学附属成功医院,解放军第174医院,361003

出　　处：《实用癌症杂志》2016年第12期2069-2072,共4页The Practical Journal of Cancer

摘　　要：目的分析成人朗格汉斯细胞组织细胞增生症(LCH)的放射治疗(RT)效果合并文献复习。方法回顾性分析经病理检查确诊的1例成人LCH患者的临床资料及放射治疗效果。结果病理检查提示:"C7椎体"骨与软组织中见淋巴细胞、浆细胞、嗜酸性粒细胞、巨噬细胞及多核巨细胞浸润,血管丰富,充血出血,伴纤维组织增生。免疫组化标记显示:病变中含有朗格汉斯细胞、组织细胞、T和B淋巴细胞及浆细胞。骨组织脱钙后见类似病变及细胞免疫表型。确诊后给予前后路联合颈7椎体切除椎管减压+肿瘤切除病检+前路钢板、钛网植骨固定+后路颈7椎体附件切除椎弓根钉内固定术和放射治疗。术后予瘤床区(P-CTV)放射治疗,瘤床区(P-CTV)放疗剂量:200cGy/f,1次/天,5次/周,共予(P-CTV)放疗剂量:2200cGy/11f。患者症状达到基本缓解,照射部位无放射治疗的副作用出现。结论放射治疗可以有效治疗成人LCH。即使是低RT剂量疗效也很好,而且副作用少。Objective To analyze the efficacy of radiation treatment for adult langerhans histiocytosis and review of the literature. Methods Retrospective analysis of the clinical data and the results of radiotherapy in 1 ease of adult langerhans histi- ocytosis confirmed by pathology were conducted. Results Pathology revealed that ＂ C7 vertebral body＂ of bone and soft tissue contain lymphocytes ,plasma cells, eosinophils, maemphages and muhinucleated giant cells, rich vascular, congestion and hemor-rhage, with fibrous tissue hyperplasia. Immunohistochemieal markers showed that diseased tissues contain langerhans ceils, tissue cells ,T and B lymphocytes and plasma cells. There were similar lesions and immunophenotype after bone demineralization. After diagnosis we gave a combined anterior and posterior approach for C7 vertebral resection and vertebral canal decompression ＋ tumor resection and disease detection ＋ anterior plate,titanium mesh and bone graft fixation of posterior cervical vertebral body resection ＋ posterior C7 vertebral appendix resection and pedicle screw fixation ＋ radiation therapy. Postoperative tumor bed area（ P- CTV） radiotherapy, the tumor bed area（P-CTV） radiation dose ：200 cGy/f, 1 times / day ,5 times / week, dose total （P-CTV） ： 2 200 cGy/1 If. The symptoms of the patients achieved a basic remission,irradiation site without any side effects of radiation ther-apy. Conclusion Radiation therapy can be effective treatment for adult langerhans histiocytosis. Even a low radiotherapy dose has good effect with less side effects.

关 键 词：组织细胞增多症 朗格汉斯细胞 成人 放射治疗 

分 类 号：R73-36[医药卫生—肿瘤]