鼻腔非霍奇金淋巴瘤的治疗与预后分析

The Treatment and Prognosis of Nasal Non-Hodgkin's Lymphoma

[目的]分析鼻腔非霍奇金淋巴瘤的预后因素。[方法]自1991年11月至2001年4月该院治疗99例Ⅰ、Ⅱ期鼻腔非霍奇金淋巴瘤 ,LDH异常10例、正常89例 ;有全身症状32例 ;12例行颈部预防照射。鼻腔靶区中位剂量54.4Gy(20.0Gy～69.5Gy)。全组1例手术后行放、化疗,1例行单纯化疗,6例单纯放疗,其余行放、化疗。放疗前、中、后行COP、COMP、CHOP、BACOP方案化疗2～8个疗程。[结果]该组病例中位生存期为70个月 ,5年生存率为66.2%。单因素及多因素分析结果显示肿瘤局部侵犯范围、LDH异常、有全身症状及分期对生存率和远处侵犯率有显著影响(P<0.01)。[结论]肿瘤局部侵犯范围、LDH异常、有全身症状及分期是影响鼻腔非霍奇金淋巴瘤生存率及远处侵犯的主要因素。Ⅰ期不必行颈部预防照射。

To investigate the prognostic factors in nasal non_Hodgkin's lymphoma (NHL).Ninety nine patients with stage Ⅰ or stage Ⅱ nasal NHL were treated between November 1991 and April 2001. Ten patients had LDH disorder. Thirty_two patients had B symptoms. Twelve patients received prophylactic neck radiation. The median radiation dose to the nasal cavity was 54.4 Gy with a range of 20.0Gy to 69.5 Gy. One patient had primary tumor resection prior to radiotherapy and chemotherapy. One patient received chemotherapy alone,6 patients radiotherapy alone and the others combination with radiotherapy and chemotherapy. The chemotherapy regimen consisted of 2～8 cycles of COP, COMP, CHOP or BACOP regimen.The median survival time was 70 months. The overall 5 year survival was 66.2%. The local invasive extent of primary tumor, LDH disorder, B symptoms and staging impacted significantly on survival rate and distant metastasis with monovariate or multivariate analysis (P<0.01). Age, gender, pathologic phenotype and prophylactic neck radiation had no significant mfluence on survival rate and distant metastasis [Conclusions]The local invasive extent of primary tumor, LDH disorder, B symptoms and staging are important factors in patients with nasal NHL. It's suggested that stage ⅠE patients with nasal NHL prophylactic neck radiation should not be offered routinely.