探讨Ⅰ,Ⅱ期非霍奇金淋巴瘤的综合治疗

Combination therapy for stageⅠ andⅡ non Hodgkin's lymphoma

目的探讨Ⅰ，Ⅱ期非霍奇金淋巴瘤（ｎｏｎ－Ｈｏｄｇｋｉｎ＇ｓｌｙｍｐｈｏｍａ，ＮＨＬ）综合治疗的有效方法。材料与方法１９８７年１月～１９８９年１２月收治ＮＨＬ１５２例，分别采用单纯放疗、放疗＋化疗、化疗＋放疗＋化疗、化疗＋放疗和单纯化疗治疗。结果Ⅰ期ＮＨＬ分别采用单纯放疗和放、化综合治疗者，其３，５，７年生存率与复发率相近。而Ⅰ期仅有结内受累者，其３，５，７年生存率单纯放疗组分别为１００．０％，１００．０％，８８．９％，放、化综合治疗组分别为８８．２％，８２．４％，５２．９％，单放组生存率较高，而复发率两组相近；Ⅱ期ＮＨＬ，放、化综合治疗组３，５，７年生存率较单纯放疗组稍高，复发率两组相近，其中高度恶性病例，化疗＋放疗＋化疗组３，５，７年生存率分别为７３．３％，７３．３％，６０．０％，较放疗＋化疗、化疗＋放疗组均高，而复发率较低。结论（１）Ⅰ期ＮＨＬ仅有结内受累者可考虑用单纯放疗。（２）Ⅱ期高度恶性ＮＨＬ推荐化疗＋放疗＋化疗方法。

Purpose To seek effective combination therapy for patients with stageⅠand Ⅱ non Hodgkin's lymphoma (NHL). Materials and Methods One hundred and fifty two patients with stageⅠand Ⅱ NHL were treated from January 1987 to December 1989. The methods of treatment included radiation alone, radiation with chemotherapy, chemotherapy followed by radiation then with chemotherapy, chemotherapy with radiation and chemotherapy alone. Results The 3 , 5 , 7 year survival rates and relapse rates were similar for patients with stage ⅠNHL either treated by radiation alone or radiation combined with chemotherapy .For patients with involvement of lymph node alone , the 3 , 5 , 7 year survival rates were 100.0%, 100.0%, 88.9% in radiation alone group and 88.2%, 82.4%, 52.9% in radiation combined with chemotherapy group. The former gave the better results. For patients with stage Ⅱ NHL, the 3 , 5 and 7 year survival rates were slightly higher in radiation combined with chemotherapy group than in radiation alone group , but the relapse rates were similar in both groups . Patients with high grade malignancy as treated by radiation combined with chemotherapy were divided into R+C, C+R+C and C+R group. The 3 , 5 and 7 year survival rates were 73.3%, 73.3%, 60.0% in group C+R+C which were better than in R+C and C+R group. Conclusion For patients with stage ⅠNHL, radiation alone can be used for patients with involvement of lymph node alone. We recommend combination therapy of C+R+C for patients with high grade stage ⅡNHL.