摘要
目的回顾分析原发性骨淋巴瘤（PBL）患者的疗效和预后因素。方法1994—2009年间本中心收治的PBL患者31例，均经病理证实为非霍奇金淋巴瘤，其中ⅠE、ⅡE、ⅣE期分别为22、4、5例。全组单纯手术1例、单纯放疗1例、单纯化疗2例、术后化疗4例、放化疗23例，放疗剂量中位数字为50Gy。结果随访时间中位数45．2个月。随访率为83．9％。随访满10年者9例。全组治疗后5、10年总生存率分别为92％、92％，无进展生存率分别为79％、70％。非联合放化疗组的完全缓解率为50％、进展或复发为2／8、复发时间中位数为6．8个月，联合放化疗组相应为65％、13％、39．1个月。单因素分析显示年龄≤50岁（χ^2=5．32，P=0．021）及美国东部肿瘤协作组（ECOG）体力状况（PS）评分0—1分（χ^2=5．48，P=0．019）为生存预后因素，国际预后指数评分≤1分（χ^2=7．81，P=0．005）及ECOGPS评分0—1分（χ^2=18．70，P=0．000）为无进展生存预后因素。结论PBL患者预后良好，放化疗应作为首选治疗方法，放疗剂量≥40Gy较安全可行。年轻及一般状况较好患者预后更好。
Objective To retrospectively analyze the treatment results and prognostic factors in patients with primary bone lymphomas （PBL）. Methods Thirty-one patients with PBL treated between April 1994 and May 2009 at Sun Yat-sen University Cancer Center were analyzed. All patients were diagnosed by pathology. Twenty-two patients had stage ⅠE, 4 patients had stage ⅡE and 5 patients had stage ⅣE diseases. One patient was treated with surgical resection alone, 1 patient with radiotherapy （RT） alone, 2 patients with chemotherapy （CT） alone and 4 patients with resection followed by chemotherapy. The remaining 23 patients received CT combined with RT. The median radiation dose was 50 Gy. Results The median follow-up time was 45.2 months. The follow-up rate was 83.9%. Nine patients had a follow-up time of 10 years. The 5-year and 10-year overall survival rates were 92% and 92%, respectively. The 5-year and 10-year disease-free survival rates were 79% and 70%, respectively. In the group who received non- combined chemoradiotherapy, the complete response rate was 50%, the incidence of progression or recurrence was 2/8 and the median recurrence time was 6. 8 months. In the group who received combined chemoradiotherapy, the complete response rate was 65% , the incidence of progression or recurrence was 13% and the median recurrence time was 39. 1 months. In univariate analyses, favorable prognostic factors for survival included age ≤ 50 years （ χ^2= 5.32, P = 0. 021 ） and ECOG PS score 0 - 1 （ χ^2= 5.48, P = 0. 019）. Favorable prognostic factors for DFS included IPI score ≤〈 1 （χ^2= 7. 81, P = 0. 005 ） and ECOG PS score 0 - 1 （ χ^2=18.70,P = 0. 000）. Conclusions Treatment results of patients with PBL can be generally well. CT combined with RT appears to be the treatment of choice. RT dose ≥40 Gy is safe and feasible. Younger age and better performance status are associated with a better outcome.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2011年第4期313-316,共4页
Chinese Journal of Radiation Oncology
