97例非何杰金淋巴瘤放射治疗

Radiotherapy of 97 Patients with NonHodgkin's Lymphoma

目的：分析非何杰金淋巴瘤（ＮＨＬ）放射治疗效果。方法：自１９８０年１月至１９９１年１１月间，用钴－６０体外照射９７例ＮＨＬ患者。局部照射１２例，扩大野照射７６例，大面积不规则野照射９例。常规照射肿瘤剂量１８０～２００ｃＧｙ／次，不规则野肿瘤剂量１４０～１８０ｃＧｙ／次，总剂量２３～６０Ｇｙ。结果：Ⅰ、Ⅱ、Ⅲ、Ⅳ期５年生存率分别为６１．５％，４０．０％，１４．３％，０。总５年生存率４６．４％。淋巴结直径≤５ｃｍ和＞５ｃｍ生存率分别为６２．２％（２３／３７），２５％（１１／４４）（Ｐ＜０．０１）。治疗结束时淋巴结残留者５年生存率２２．７％（１０／４４），全消者５年生存率６４．９％（２４／３７），（Ｐ＜０．０１）；野内复发占１９．１％，野外复发占８０．９％，死于野内、外复发者分别占１５．８％和８４．２％。结论：淋巴结直经＞５ｃｍ或治疗结束时淋巴结残留者预后差；

Objective:To analyze the results of nonHodgkin's lymphoma treated by radiotherapy. Methods: From January 1980 to November 1991,97 patients with nonHodgkin's lyphoma were treated by radiotherapy with cobalt.Twelve patients,seventysix patients and nine patients were treated by local irradiation, extended fields with DT 180～200 cGy every fraction and irregular large fields with DT140～180 cGy every fraction respectively.Total doses were 23～60 Gy. Results: The total 5year survival rate was 46.4%; The 5year survival rates for stage Ⅰ、Ⅱ、Ⅲ、Ⅳ were 61.5%,40%,14.3%,zero respectively. The 5year survival rates with lymph node diameter ≤5 cm or >5 cm were 62.2%,25% respectively (P<0.01). The 5year survival rates with residual tumor or complete response were 22.7% and 64.9%, (P<0.01). The rates of recurrence in or out of fields were 19.1% and 80.9%. The cases died of recurrence in or out of fields were 15.8%(6/38) and 84.2%(32/38). respectively. Conclusions: The prognoses were poor for cases with lymph node diameter >5cm or residual tumor at the end of the course of treatment. The recurrence was the major reason of failure for NHL.