LONG-TERM OUTCOME AND PATTERNS OF FAILURE IN PRIMARY OCULAR ADNEXAL MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMATREATED WITH RADIOTHERAPY
LONG-TERM OUTCOME AND PATTERNS OF FAILURE IN PRIMARY OCULAR ADNEXAL MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMATREATED WITH RADIOTHERAPY
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DOI：
10.1016/j.ijrobp.2011.04.052
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发表时间：
2012-03-15
影响因子：
7
通讯作者：
Sugimura, Kazuro
中科院分区：
文献类型：
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作者：
Hashimoto, Naoki;Sasaki, Ryohei;Sugimura, Kazuro
目的：评价放射治疗后原发性眼附属器粘膜相关淋巴组织淋巴瘤（POAML）的长期治疗结果和疾病行为。方法和材料：纳入1991年至2010年在科比大学医院诊断为I期POAML的78例患者（男42例，女36例）。中位年龄为60岁（范围：22-85岁）。中位放射剂量为30.6戈伊。20例患者（25.6%）接受了基于利妥昔单抗的靶向治疗和/或化疗。局部控制（LC），无复发生存（RFS）和总生存（OS）率采用Kaplan-Meier方法计算。主要肿瘤部位为结膜37例（47.4%），眼眶29例（37.2%），泪腺12例（15.4%）。5年和10年OS率分别为98.1%和95.3%。5年和10年LC率均为100%，5年和10年RFS率分别为88.5%和75.9%。与单独接受放疗的患者相比，接受放疗和靶向治疗和/或化疗联合治疗的患者有更好的RFS趋势（p = 0.114）。没有发生超过2级的急性发病率。有14例患者经历了2级发病率（白内障：14;视网膜疾病：7;干眼：3），23例患者有3级发病率（白内障：23;干眼：1），和1例患者有4级glaucoma.Conclusions：POAML的放射治疗被证明是高效和安全的LC和OS的长期观察的基础上。联合治疗的患者没有全身复发，这表明低剂量放射联合靶向治疗可能值得进一步研究。(C)2012 Elsevier Inc.
Purpose: To evaluate the long-term treatment outcome and disease behavior of primary ocular adnexal MALT (mucosa-associated lymphoid tissue) lymphoma (POAML) after treatment with radiotherapy.Methods and Materials: Seventy-eight patients (42 male, 36 female) diagnosed with stage I POAML between 1991 and 2010 at Kobe University Hospital were included. The median age was 60 years (range, 22-85 years). The median radiation dose administered was 30.6 Gy. Rituximab-based targeted therapy and/or chemotherapy was performed in 20 patients (25.6%). Local control (LC), recurrence-free survival (RFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method.Results: The median follow-up duration was 66 months. Major tumor sites were conjunctiva in 37 patients (47.4%), orbita in 29 (37.2%), and lacrimal glands in 12 (15.4%). The 5- and 10-year OS rates were 98.1% and 95.3%, respectively. The 5- and 10-year LC rates were both 100%, and the 5-and 10-year RFS rates were 88.5% and 75.9%, respectively. Patients treated with a combination of radiotherapy and targeted therapy and/or chemotherapy had a trend for a better RFS compared with those treated with radiotherapy alone (p = 0.114). None developed greater than Grade 2 acute morbidity. There were 14 patients who experienced Grade 2 morbidities (cataract: 14; retinal disorders: 7; dry eye: 3), 23 patients who had Grade 3 morbidities (cataract: 23; dry eye: 1), and 1 patient who had Grade 4 glaucoma.Conclusions: Radiotherapy for POAML was shown to be highly effective and safe for LC and OS on the basis of long-term observation. The absence of systemic relapse in patients with combined-modality treatment suggests that lower doses of radiation combined with targeted therapy may be worth further study. (C) 2012 Elsevier Inc.