放疗、化疗综合治疗眼眶原发恶性淋巴瘤分析

The combined therapy of radiotherapy and chemotherapy of primary malignant lymphoma of the orbit

目的评价放疗、化疗综合治疗眼眶原发性恶性淋巴瘤的临床价值。方法9例眼眶原发性恶性淋巴瘤患者,1例仅采用化疗,COBP化疗方案,8例采用放疗+化疗联合治疗,1～2周期化疗后放疗,放疗后再3～4周期化疗,化疗方案以COP或CHOP,6MVX线、6￣9Mev高能电子线单前野或两前斜野照射,总剂量26￣50Gy,13￣25次,3￣5周,中位40Gy。结果所有患者放疗、化疗耐受性良好,结膜炎、角膜溃疡症状轻,对症处理后缓解,未出现视力下降等严重并发症,局部控制率为100%,5年生存率85%。结论局部放射治疗是眼眶原发性恶性淋巴瘤有效的治疗方法,推荐放射剂量35～40Gy,不需行淋巴引流区预防性照射,对有眶外侵犯者应加化疗。

Objective To evaluate the treatment results of primary orbital lymphoma. Methods 9 cases patients with primary orbital lymphoma were treated. Among the cases were stage I. 1 case received chemotherapy only, COBP;8 cases recived radiotherapy plus chemotherapy. The patients recived radiotherapy of the dose 26-50Gy with 3-5weeks after 1 -2 cycles chemotherapy, 3-4 cycles chemotherapy after the radiotherapy. Results Local control rate was 100% and 5-year survival was 85%. Conclusions Carefully planned radiotherapy is an effective and safe treatment in the management of orbital lymphoma. Radiation dose of 35-40Gy appears to be a sufficient dose .The late complications were cataract and lacrimal dysfunction . Chemotherapy should be given to those patients systematic spread.