Tomita T, Fujii M, Imanishi Y, Kanke M, Kanzaki J, Ohno Y, Tokumaru Y, Inuyama Y
Department of Otolaryngology, Keio University School of Medicine, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 1999 Jun;102(6):809-17. doi: 10.3950/jibiinkoka.102.809.
Prognostic factors and treatment outcome of 48 patients with Stage I (29) or II (19) non-Hodgkin's lymphoma of the head and neck were analyzed retrospectively. There were 26 males and 22 females, aged from 15 to 89 years old, with an average age of 57. The primary lesion was located in Waldeyer's ring in 25 patients, the nasal cavity and paranasal sinuses in 13, cervical lymph nodes in 8, and others in 2. Histologically, 2 had low grade lymphoma, 42 had intermediate grade disease, and 1 had high grade disease. The patients were treated with radiation alone (5 patients), chemotherapy according to a cyclophosphamide, doxorubicin, vincristine, prednisone- (CHOP) regimen (8 patients), or a combination of both treatments (35 patients). In univariate analyses, an unfavorable prognosis was associated with age > or = 60, Stage I disease, and extralymphatic lesion. Multivariate analysis showed that an extralymphatic lesion was a significant independent risk factor for death (p = 0.0093). The overall five-year survival rate was 73.5%. Differences in the treatment was not reflected in the outcome. Our results suggest that a combination of chemotherapy (CHOP) and radiation is an appropriate treatment for lymphatic stage I and II non-Hodgkin's lymphoma of the head and neck. However, more intensive therapy is necessary for patients with extralymphatic head and neck NHL.
对48例I期(29例)或II期(19例)头颈部非霍奇金淋巴瘤患者的预后因素及治疗结果进行了回顾性分析。患者中男性26例,女性22例,年龄15至89岁,平均年龄57岁。原发灶位于Waldeyer环者25例,鼻腔及鼻窦13例,颈部淋巴结8例,其他部位2例。组织学检查,2例为低度淋巴瘤,42例为中度淋巴瘤,1例为高度淋巴瘤。患者接受单纯放疗(5例)、环磷酰胺、阿霉素、长春新碱、泼尼松(CHOP)方案化疗(8例)或两种治疗联合(35例)。单因素分析显示,年龄≥60岁、I期疾病及结外病变与预后不良相关。多因素分析表明,结外病变是死亡的显著独立危险因素(p = 0.0093)。总体五年生存率为73.5%。治疗差异未体现在结果中。我们的结果提示,化疗(CHOP)与放疗联合是头颈部I期和II期非霍奇金淋巴瘤的合适治疗方法。然而,结外头颈部非霍奇金淋巴瘤患者需要更强化的治疗。