摘要
目的 :探讨鼻腔非霍奇金淋巴瘤 (NHL)的预后及影响因素。方法 :1985年 2月～ 1996年 7月间共收治 14 3鼻腔NHL采用放疗、化疗和放、化疗综合治疗。结果 :76例治疗成功占 5 3.1% (76 / 14 3)。远处结外器官受侵是治疗失败的主要原因 ,其中以皮肤皮下最多见 ,淋巴结受侵和局部失败少见。治疗失败和临床分期相关 ,Ⅰ期局部和远处复发为 2 9.7% (30 / 10 1) ,中晚期局部和远处复发分别为 87.5 % (2 8/ 32 )、90 .0 % (9/ 10 )。T细胞淋巴瘤与B细胞淋巴瘤远处器官受侵分别为 5 4 .2 % (45 / 83)、35 .9% (14 / 39)。在病变超出鼻腔侵犯邻近器官的Ⅰ期患者中 ,综合治疗组和单纯放疗组远处失败基本相似。Ⅱ期综合治疗患者远处器官受侵明显低于单纯放疗患者。结论 :有效的化疗方案能减少中晚期NHL患者远处器官受侵 ,提高生存率。复发多在 2年内发生 ,复发患者的再治效果差。
Purpose:To analyze the prognostic factors of non-Hodgkin's lymphoma in nasal cavity.Methods:From Feb. 1985 to Jul. 1996, 143 patientsof non- Hodgkin's lymphoma in nasal cavity have been treated in our hospital by radiotherapy alone, chemotherapy alone and radiotherapy with chemotherapy.Results:The complete response rate of all 143 patients was 53.1%(70/143). The main failure site is distant extranodal infiltration especially the invasion of skin. Failure at primary site and lymph node is not common. The main factor influencing local and distant failure is the stage of disease.The failure rate of stage Ⅰ, stageⅡ and stageⅢ-Ⅳ is 29.7%(30/101),87.5%(28/32) and 90.0%(9/10), respectively . The distant extranode invasion rate is 54.2%(45/83) and 35.9%(14/39) in T cell and B cell type disease respectively. In those stage Ⅰ patients with lesions beyond nasal cavity , the distant failure rate have not shown any difference between groups of radiotherapy alone and radiotherapy with chemotherapy. In contrast, in patients of stageⅡ～Ⅳ disease, the distant failure rate is less in patients received radiotherapy with chemotherapy than in patients received radiotherapy alone. Conclusions:Chemotherapy could improve the survival rate and decrease the distant failures for the patients of advanced non- Hodgkin's lymphoma in nasal cavity. The failures always occur in 2 weeks after initial treatment and the prognosis of the failure patients is very poor.
出处
《中国癌症杂志》
CAS
CSCD
2003年第5期456-458,461,共4页
China Oncology
