IE期原发眼附属器黏膜相关淋巴组织淋巴瘤的放疗效果分析

Clinical efficacy of radiotherapy for stage IE Primary ocular adnexal mucosa associated lymphoid tissue lymphoma

目的评价IE期原发眼附属器黏膜相关淋巴组织淋巴瘤放疗剂量效应和预后。方法回顾分析2003-2015年单纯放疗93例(117只眼)IE期原发眼附属器黏膜相关淋巴组织淋巴瘤患者资料。通过眼球突出度的改变观察剂量效应。采用Kaplan Meier法计算生存率并Logrand法检验和单因素预后分析。结果照射剂量≥27Gy者眼球突出度缓解率为69%(29/42),眼球突出度缓解中位剂量7.2(5.4~19.8)Gy。全组患者局部控制率100%。全组患者5、10年总生存率分别为92%、82%,病因特异性生存率均为98%,无进展生存率分别为90%、88%。单因素分析显示国际预后指数、年龄是无进展生存的预后因素(P=0.04、0.04)。结论原发眼附属器黏膜相关淋巴组织淋巴瘤对放疗敏感。单纯放疗可以获得局部控制和长期生存。处方剂量18Gy可以获得满意的疗效。

Objective To evaluate the dose response and prognosis of patients with stage I E primary ocular adnexal mucosa associated lymphoid tissue lymphoma(POAml)treated with radiotherapy.Methods Clinical date of 93 patients(117 eyes)with stage IE POAml treated from November 2003 to July 2015 were retrospectively analyzed.The dose response was evaluated by observing the ocular changes in exophthalmos.The survival rate was calculated by using the Kaplan-Meier survival analysis.The log-rank test and univariate analysis were used for prognostic analysis.Results For patients treated with a dose of≥27 Gy,the response rate of exophthalmos was 69.0%(29/42).The median response dose was 7.2 Gy(5.4-19.8 Gy).For all patients,the local control rate was 100%.The 5-and 10-year overall survival(OS)rates were 92%and 82%.The 5-and 10-year cause-specific survival(CSS)rates were equally 98%.The 5-and 10-year progression-free survival(PFS)rate were 90%and 88%.The univariate prognostic analysis demonstrated that the International Prognostic Index(IPI)score and age were the prognostic factors of PFS rate(both P=0.04).Conclusions POAml is sensitive to radiation therapy.Radiotherapy alone can yield excellent local control and long-term survival in POAml patients.A prescription dosage of 18 Gy dose can obtain favorable clinical efficacy.