放射治疗皮肤B细胞淋巴瘤30例临床分析

Radiotherapy in 30 Patients with Cutaneous B-cell Lymphoma

目的根据WHO／EORTC最新分期，报告30例原发性皮肤B细胞淋巴瘤患者的放疗效果。方法选取30例皮肤B细胞淋巴瘤患者接受皮肤放射治疗。根据病灶数量及病灶部位分别将患者分组。使用的治疗机为SATURNE CLINAC。统计软件为SPSS10．0。结果完全缓解（CR）为86％，完全缓解时间4-301个月；3例患者部分缓解（PR）为11％；1例进展。患者10年总生存率为87％。3例患者死亡（1例PCMBCL，2例PCLBCL小腿型29％）。所有患者都能耐受放疗。结论根据WHO／EORTC分期，PC—MBCL和PCFCL生存率高。PCLBCL下肢型预后较差。局部野对局部病灶有治疗效果，并能保持长期缓解。弥散病灶患者通常采用扩展野和／或化疗。对于进展期的病人，化疗是治疗选择，同时使用局部野治疗获得良好的姑息疗效。

Objective To report results of the treatment with radiation therapy of 30 patients affected by B-cell lymphoma with initial cutaneous presentation according to the new classification of WHO/ EORTC. Methods From 30 patients with cutaneous B-cell lymphoma （CBCL） have been by cutaneous irradiation.. According the number lesions and the localisation lesions, patients staged as different groups. Treatment was realised by SATURNE LINAC. For statistics SPSS10.0 software was used. Results The complete response （CR） to the treatment for our series was 86 %. The length of complete remission ranged from 4 to 301 months. Three patients （11%） was obtained partial response （PR）. One patient was progressive. Disease-free survival （DFS） at 10 years was 87%. Three patients died [One PCMBCL tow PCLBCL leg type （29%）]. Radiotherapy was generally well tolerated. Conclusion According to the WHO/EORTC classification, the result of survivor was good for PCMBCL and PCFCL. PCLBCL leg type was bad prognosis. Localized field irradiation is an effective treatment for some localized forms of primary cutaneous B-cell lymphoma and can obtain prolonged remissions. The patients with wide-spread skin involvement are usually candidates for extended field irradiation and/or chemotherapy. For the advanced stages of cutaneous B-cell lymphoma, where the chemotherapy is the treatment of choice, some good palliation can be achieved using local field irradiation.