胃肠道淋巴瘤放疗进展  

Recent progress in radiation therapy for primary gastrointestinal lymphoma

作　　者：李晔雄[1] Li Yexiong(Department of Radiotherapy, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100021, China)

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院放疗科,北京100021

出　　处：《中华结直肠疾病电子杂志》2016年第2期114-120,共7页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：国家863计划(国家高技术研究发展计划)子课题(863-306-ZD13-03-2);卫生部/吴阶平医学基金会(WKJ2005-3-006);国家自然科学基金重点项目(10335050);卫生部临床学科重点项目(07090010);国家863课题(2006AA02Z345)

摘　　要：原发胃肠道淋巴瘤是最常见的结外非霍奇金淋巴瘤。胃肠道淋巴瘤为异质性的肿瘤,弥漫大B细胞淋巴瘤和粘膜相关淋巴瘤是最常见的病理类型,放疗在不同部位和病理类型的淋巴瘤治疗中地位不同。原发胃淋巴瘤接受保留胃功能的治疗可取得良好预后,弥漫大B细胞淋巴瘤化疗后(包括完全缓解)接受放疗可提高局控率和生存率,美罗华时代大肿块患者仍需要接受放疗以提高局部控制率。早期胃MALT淋巴瘤抗HP失败后,接受单纯放疗即可取得良好的预后。原发肠道侵袭性淋巴瘤的治愈手段仍为外科治疗,惰性淋巴瘤亦可选择放疗。The gastrointestinal tract is the most common extranodal site of non-Hodgkinlymphoma. The gastrointestinal lymphoma represents a heterogeneous disease, where diffuse large B-celllymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma are the most commonsubtypes. The role of radiotherapy varies in the treatment of lymphomas from different sites or with differentsubtypes. Conservative treatment using chemotherapy and/or radiotherapy produced favorable outcomes ingastric lymphoma. In gastric DLBCL, radiotherapy after chemotherapy improved locoregional control andsurvival, even for patients who achieved complete response after chemotherapy. In the era of rituximab,radiotherapy also improved locoregional control in patients with bulky disease. In gastric MALT lymphoma,radiotherapy alone could yield excellent outcomes for patients who are unresponsive to H. pylori eradication.However, surgery remains the mainstay of radical treatment for intestinal lymphoma, and radiotherapy is alsoa choice for indolent subtypes.

关 键 词：胃肠道 淋巴瘤 非霍奇金 弥漫大B细胞淋巴瘤 粘膜相关淋巴瘤 

分 类 号：R735[医药卫生—肿瘤]