Treatment results of radiotherapy for malignant lymphoma of the orbit and histopathologic review according to the who classification
Treatment results of radiotherapy for malignant lymphoma of the orbit and histopathologic review according to the who classification
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DOI：
10.1016/s0360-3016(03)00506-6
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发表时间：
2003-09-01
影响因子：
7
通讯作者：
Nakano, T
中科院分区：
文献类型：
--
作者：
Hasegawa, M;Kojima, M;Nakano, T
目的：目的：分析眼眶恶性淋巴瘤的放射治疗结果，并与世界卫生组织（WHO）2001年公布的分类标准进行比较。方法：回顾性分析1978 ~ 2001年在日本群马大学附属医院接受放射治疗的29例眼眶恶性淋巴瘤患者的临床资料。23例病例的病理切片可用，并由血液病理学家根据WHO分类进行审查。分析原始诊断和回顾性诊断、患者特征、治疗结果和并发症。原则上，低级别或惰性淋巴瘤患者仅接受RT治疗，肿瘤剂量为30戈伊。生存数据计算使用Kaplan-Meier方法。结果：1例被证明是一个假瘤被排除在外的评价。在28例病例中，25例为IAE期，1例为IIAE期，2例为IVAE期。中位随访时间为71个月。根据原始分类和工作公式，低度恶性淋巴瘤患者的5年和10年总生存率分别为94%和73%。中度淋巴瘤的相应发生率分别为67%和67%（p = 0.15）。与此相反，WHO分类显示出生存曲线的显著差异。粘膜相关淋巴组织（MALT）淋巴瘤患者的5年和10年总生存率分别为100%和88%;弥漫性大B细胞淋巴瘤患者的5年和10年总生存率均为0%（p < 0.001）。在MALT淋巴瘤患者中，发生了1例局部复发和4例远处复发;其中2例在初始治疗后>10年。结论：眼眶MALT淋巴瘤单纯放疗可获得良好的局部控制和生存率。建议使用WHO分类和>10年的长期随访进行精确的组织病理学诊断。(C)2003年爱思唯尔公司
Purpose: To analyze the results of radiotherapy (RT) for malignant lymphoma of the orbit and to evaluate them compared with the World Health Organization (WHO) classification published in 2001.Methods and Materials: The data from 29 patients with malignant lymphoma of the orbit treated with RT at Gunma University Hospital between 1978 and 2001 were retrospectively analyzed. Pathologic slides from 23 cases were available and were reviewed by a hematopathologist according to the WHO classification. The original and reviewed diagnoses, patient characteristics, treatment results, and complications were analyzed. In principle, patients with low-grade or indolent lymphoma were treated with RT alone, using 30 Gy as the tumor dose. Survival data were calculated using the Kaplan-Meier method.Results: One case that proved to be a pseudotumor was excluded from evaluation. Of the 28 cases, 25 were Stage IAE, 1 was Stage IIAE, and 2 were Stage IVAE. The median follow-up was 71 months. According to the original classification and the Working Formulation, the 5- and 10-year overall survival rate of patients with low-grade lymphoma was 94% and 73%, respectively. The corresponding rates for those with intermediate-grade lymphoma were 67% and 67% (p = 0.15). In contrast, the WHO classification showed a significant difference in the survival curves. The 5- and 10-year overall survival rate of patients with mucosa-associated lymphoid tissue (MALT) lymphoma was 100% and 88%, respectively; for diffuse large B-cell patients, the rates were both 0% (p < 0.001). In patients with MALT lymphoma, one local and four distant relapses developed; two of them >10 years after initial treatment. All of the relapsed MALT lymphomas were controlled by salvage therapy.Conclusion: Excellent local control and'survival can be achieved for patients with orbital MALT lymphoma using RT alone. A precise histopathologic diagnosis using the WHO classification and long-term follow-up for >10 years is recommended. (C) 2003 Elsevier Inc.