41例原发肠道淋巴瘤的治疗结果

Outcome of 41 patients with primary intestinal non-Hodgkin lymphoma

目的 分析4 1例原发肠道淋巴瘤的治疗结果。方法 回顾性分析4 1例原发肠道淋巴瘤,均经手术病理证实为弥漫性非霍奇金淋巴瘤。原发部位为回盲部2 3例,升结肠10例,回肠4例,空肠1例,直肠3例。临床分期为Ⅰ期2 5例,Ⅱ期13例,Ⅲ期3例。2例肠镜活检,39例接受手术治疗。32例手术完整切除,7例大体残留。1例手术大体残留未做任何辅助治疗,8例大体残留或活检术后接受放疗或(和)化疗(不全切术+放化疗) ,13例单纯根治术(单纯手术) ,19例根治术后接受放疗或(和)化疗(全切术+放化疗)。结果 全组患者的5、10年生存率分别为5 1.9%、4 4 .5 %。5、10年无瘤生存率分别为4 3.5 %、38.7% ,放疗和化疗均能显著提高无瘤生存率(P =0 .0 12 ,P =0 .0 19)。单纯手术组的5年无瘤生存率为17.6 % ,明显低于全切术+放疗或化疗组的5 2 .7%和不全切术+放疗或化疗组的5 7.1% (P =0 .0 0 2 )。结论 建议对原发肠道淋巴瘤采用综合治疗。

Objective Objective To study the prognostic factors and treatment outcome of primary intestinal non-Hodgkin lymphoma. Methods Fort y-one patients with patholo gically confirmed primary intestinal non-Hodgkin lymphoma were retrospectively a nalyzed. The primary site was ileocecum in 23, ascending colon in 10, ileum in 4 , jejunum in 1 and rectum in 3 patients. Twenty-five patients were in stage I, 1 3 in stage Ⅱ and 3 in stage Ⅲ according to Ann Arbor staging system. Two pati ents were diagnosed by biopsy through rectal endoscope, the remaining 39 underwe nt exploratory laparotomy. Complete resection was done in 32 and partial resecti on in 7. Excluding 1 patient with partial resection only, the remaining 40 patie nts were divided into three groups according their method of treatment: 8 with c hemotherapy and/or radiotherapy following partial resection or biopsy (R2+C/R), 13 complete resection only (R0 alone), 19 chemotherapy and/or radiotherapy follo wing complete resection(R0+C+R). Results The 5- and 1 0-year overall survival (O S) rates were 51.9% and 44.5%. The 5- and 10-year disease-free survival (DFS) ra tes were 43.5% and 38.7%. Both chemotherapy and radiotherapy could improve DFS ( P=0.012 and P=0.019). R0 alone group had the wor st DFS as compared with R2+C/R o r R0+C+R group (P=0.002), whereas no difference was observed bet ween the latter two groups. Conclusion Multi-modality treatment is r ecommended for primary intestinal non-Hodgkin lymphoma.