眼眶淋巴瘤的治疗及预后研究进展

Research progress on the treatment and prognosis of orbital lymphomas

眼眶淋巴瘤(OLs)是成年人常见的眼眶恶性肿瘤。迄今已提出许多OLs的治疗方法,包括放射治疗、化学疗法、免疫治疗、抗生素治疗、手术或联合治疗等,但最佳治疗方案的选择仍然是一项涉及多学科的任务。依据组织病理学分型和临床分期的不同,OLs将采用不同的治疗方案。放射治疗通常是原发性低级别OLs的首选治疗方案,特别是MALT淋巴瘤;其他非MALT组织学亚型的OLs也可选择放射治疗,但其疗效通常不如MALT淋巴瘤。而高级别以及其他复发或难治性OLs常选择化学疗法。目前,利妥昔单抗联合CHOP的化学免疫疗法可明显改善高级别OLs的预后。而抗生素可能对鹦鹉热衣原体感染相关的MALT淋巴瘤患者中的一小部分有效。研究显示,OLs病理组织学分型和临床分期也是影响其预后的主要因素。高级别淋巴瘤预后较差,而低级别淋巴瘤预后良好;年龄、性别、疾病原发部位和各种治疗方案等因素也与其预后密切相关。本文对国内外OLs治疗及预后因素的相关研究进行综述,以期为临床治疗方案的制定和预后效果评估提供参考。

Orbital lymphomas(OLs)are the common orbital malignancies in adults.To date,many studies have reported the treatment of OLs,including radiotherapy,chemotherapy,immunotherapy,antibiotic therapy,surgical resection,or combination therapy.However,the selection of the best treatment is still a multidisciplinary task.Different treatment schemes were adopted for different subtypes and clinical stages of OLs.Radiotherapy is usually the first choice for the treatment of primary low-grade OLs,especially MALT lymphomas.Other non-MALT lymphomas can also be treated with radiotherapy,but the efficacy is not as good as MALT lymphomas.Chemotherapy is the most common choice for high-grade and other recurrent or refractory OLs.At present,rituximab combined with CHOP can significantly improve the prognosis of high-grade OLs.And antibiotics may be effective against a small portion of MALT lymphomas associated with Chlamydia psittaci infection.Also,studies have shown that histopathological subtypes and clinical stages are the most important factors affecting the prognosis of OLs.High-grade lymphomas have a poor prognosis,while the prognosis of low-grade lymphomas is better.Age,sex,the primary site of the disease and the use of various treatments are also related to prognostic outcomes of OLs.This article reviews the research on the treatment and prognostic factors of OLs at home and abroad to provide a reference for the formulation of clinical treatment plans and evaluate the prognosis.