原发性喉恶性淋巴瘤19例临床分析

Clinical analysis of primary non Hodgkin’s lymphoma of the larynx: a report of 19 cases

目的 根据 19例原发性喉恶性淋巴瘤 ,结合文献分析该病的临床、病理、治疗及预后。方法 19例中声门上区 14例 ,声门区 5例。间接喉镜或纤维喉镜下呈粘膜光滑肿瘤 14例 ,坏死糜烂性改变 5例。病理均为非霍奇金淋巴瘤 (NHL)。B细胞NHL 9例 ,T细胞NHL 10例 ,其中中线T细胞NHL 5例。治疗均以放射治疗为主 ,采用 6MVX射线或6 0 Coγ射线 ,以局部野为主。照射野后部分加照 9～ 12MeV电子线。放射治疗前后 12例做以COMP方案为主的化疗 1～ 5个周期。结果 5年生存率为 6 3 .2 %。死亡 7例 ,均死于远处受累。结论 本组提示喉NHL中中线T细胞淋巴瘤明显多于欧美。放射治疗的局部控制作用良好 。

Objective To investigate the clinical and pathologic features, treatment results and prognostic factors of non Hodgkin’s lymphoma (NHL) of the larynx. Methods Nineteen patients with primary NHL of larynx were treated between 1975 and 1996. Fourteen patients had primary tumor in the supraglottic regions, and 5 in the glottic regions. On laryngoscopy, 14 cases manifested smooth mucosal mass and 5, necrotic changes. All patients were pathologically proven to be NHL. There were 9 patients B cell lymphoma and 10 T cell lymphoma. All patients were treated by radiotherapy as the primary treatment with majority of patients with local small fields. Radiotherapy was given with telecobalt 60 or 6 MV X. Results The 5 year survival rate was 63.2% . All seven patients who died did so of distant involvement. Conclusion Radiotherapy is able to achieve a good tumor local control and is a primary treatment for patients with NHL of the larynx.