放射治疗ⅠE期非结膜眼附属器黏膜相关淋巴组织型淋巴瘤的剂量效应和预后

Non-conjunctival primary ocular adnexal mucosa associated lymphoid tissue lymphoma(POAML) treated with primary radiotherapy

目的评价放射治疗ⅠE期非结膜原发眼附属器黏膜相关淋巴组织型淋巴瘤的剂量效应和预后。方法回顾性分析2003-11至2012-03收治的影像资料完整可测量33例(42只眼)ⅠE期非结膜原发眼附属器黏膜相关淋巴组织型淋巴瘤患者资料。结果照射剂量18 Gy时与27 Gy时,依据WHO标准评价疗效,缓解率分别为31%和42.9%(P=0.258);依据RECIST标准评价疗效,缓解率分别为28.6和38.1%(P=0.355)。全组患者局部控制率100%。全组患者的5年、10年总生存(OS)率分别为96.8%和84.7%;5、10年无进展生存(PFS)率分别为89.6%和89.6%。接受≥30.6Gy组与27 Gy组,5、10年总生存(OS)率分别为100%、80%和95.7%、95.7%(P=0.8578);5、10年无进展生存(PFS)生存率分别为83.3%、83.3%和91.1%、91.1%(P=0.6497)。结论非结膜原发眼附属器黏膜相关淋巴组织型淋巴瘤对放射治疗敏感。从局部控制和长期生存的观察结果显示,27 Gy的照射剂量是足够的。探索最佳的照射剂量需要开展前瞻性大样本的剂量效应观察研究。

Objective To evaluate the dose response of patients with ⅠE stage non-conjunctival primary ocular adnexal mucosa associated lymphoid tissue lymphoma（ POAML） treated with primary radiotherapy. Methods Clinical data on thirty-three patients（ 42 eyes） with stage Ⅰ non-conjunctival POAML treated between November 2003 and Match 2012 were retrospectively studied.Results For all the patients,the local control rate was 100% at the dose of 18 Gy and 27 Gy,while the response rate was 31%and42. 9%（ P = 0. 258） respectively as measured with the WHO criteria. However,the response rate was 28. 6% and38. 1%（ P =0. 355） respectively as measured with the RECIST criteria. For patients of non-conjunctival POAML treated at the dose of ≥30. 6 Gy and 27 Gy,the five-year overall survival（ OS） rate was 100% and 95. 7% respectively（ P = 0. 8578）,and the five-year progressionfree survival（ PFS） rate was 83. 3% and 91. 1% respectively（ P = 0. 6497）. Conclusions The prescribed dose of 27 Gy for non-conjunctival POAML seems to be effective. Prospective clinical studies should be carried out to define the optimal dose for POAML.