Ⅰ期颈淋巴结非霍奇金淋巴瘤的治疗及预后分析  

Stage Ⅰ nodal non-Hodgkin's lymphoma in the neck region: treatment and prognosis

作　　者：查文武[1] 顾仲义[1] 陆进成[1] 朱向帜[1] 倪明[1] 

机构地区：[1]江苏省肿瘤防治研究所肿瘤医院放射治疗科,南京210009

出　　处：《中华放射肿瘤学杂志》2003年第2期96-99,共4页Chinese Journal of Radiation Oncology

摘　　要：的　回顾性分析Ⅰ期颈淋巴结非霍奇金淋巴瘤 (NHL)的治疗结果和预后因素。方法　Ⅰ期颈淋巴结NHL 85例 ,男性 5 9例 ,女性 2 6例。肿块 <5cm 39例 ,≥ 5cm 4 6例。按工作分类法分类 :低度恶性 7例 ,中度恶性 6 4例 ,高度恶性 4例 ,未分类型 10例。单纯放射治疗 11例 ,放射治疗 +化疗 19例 ,化疗 +放射治疗 2 8例 ,化疗 +放射治疗 +化疗 19例 ,单纯化疗 8例。放射治疗采用面颈联合野和颈部切线野照射 ,照射剂量DT4 0～ 6 0Gy。化疗以COMP和CHOP方案为主 ,多为 4～ 6周期。应用Kaplan Meier方法进行生存分析 ,Logrank方法进行差异显著性检验。结果　全组病例5年生存率为 80 .9% ,无复发生存率为 75 .0 %。病理低、中、高度恶性和未分类型的 5年生存率分别为 10 0 %、79.6 %、75 .0 %和 80 .0 % (P >0 .0 5 )。单纯放射治疗、放射治疗 +化疗、化疗 +放射治疗、化疗 +放射治疗 +化疗和单纯化疗的 5年生存率分别为 81.8%、73.3%、78.6 %、82 .1%和 10 0 % (P>0 .0 5 )。肿瘤最大径 <5cm和≥ 5cm的 5年生存率分别为 92 .1%和 71.4 % (P <0 .0 5 )。初始治疗后达CR与未达CR的 5年生存率分别为 85 .8%和 6 5 .5 % (P <0 .0 1)。结论　Ⅰ期颈淋巴结NHL治疗效果满意 ,5年生存率高达 81.0 %。性别、年龄、病理类型?Objective To evaluate the treatment results and prognositic factors of stage Ⅰ nodal non-Hodgkin's lymphoma in the neck region. Methods Eighty-five patients with stage Ι nodal NHL in the neck region were treated from January 1987 to December 1997. There were 59 males and 26 females. The tumor diameter was <5?cm in 39 and ≥5?cm in 46 patients. Working Formulation was used in pathologic classification, with 7 low-grade, 64 intermediate, 4 high-grade and 10 unclassified. Patients were treated by radiotherapy alone (R) in 11, radiotherapy plus chemotherapy (R+C) in 19, chemotherapy plus radiotherapy (C+R) in 28, chemotherapy plus radiotherapy plus chemotherapy (C+R+C) in 19 and chemotherapy alone (C) in 8. Kaplan-Meier method and Log-rank test were used in survival analysis. Results The 5-year accumulated survival rate for the entire group was 80.9%. The 5-year survival rates of patients with low-grade, intermediate, high-grade and unclassified pathology were 100%, 79.6%, 75.0%, and 80.0%(P=0.34), without any significant difference. The 5-year survival rates of patients treated with the different methods were: R 81.8% , R+C 73.3%, C+R 78.6%, C+R+C 82.1% and C 100% (P=0.94), also with no significant difference. For patients with tumor diameter <5?cm and ≥5?cm, the 5-year survival rates were 92.1% and 71.4%(P=0.02), with the difference significant. The 5-year survival rate was significantly improved in patients who had achieved CR following the primary treatment than those in whom only PR was achieved (85.8% vs 65.5%, P<0.01). Conclusions The treatment results of patients with stage Ⅰ nodal NHL in the neck region was satisfactory, with the 5-year survival rate reaching 81.0%. Age, pathologic classification, and treatment modality are not significant prognostic factors, while tumor size,involved site, primary treatment response are significant prognostic factors.

关 键 词：Ⅰ期 颈淋巴结 非霍奇金淋巴瘤 治疗 肿瘤 化疗 NHL 放射治疗 

分 类 号：R733.4[医药卫生—肿瘤] R739.91[医药卫生—临床医学]