Neumann Holger, Blanck Hilpert, Koch Rainer, Fiedler Steffen, Lesche Aquina, Herrmann Thomas
Praxis für Strahlentherapie, Humaine-Klinik Dresden, Dresden.
Strahlenther Onkol. 2003 Dec;179(12):840-6. doi: 10.1007/s00066-003-1025-0.
Radiotherapy is a curative treatment modality in the early stages of follicle centre lymphoma. Survival rates, patterns of failure and prognostic factors were evaluated in a retrospective analysis.
116 patients with follicle centre lymphoma stage I and II were treated between 1970 and 1999 in Dresden. Therapy modalities were radiotherapy alone (103 patients) or combined radiotherapy/chemotherapy (13 patients). Radiotherapy was applied as involved-field-(IFI)- (104 patients), extended-field- (nine patients) or total-nodal- (three patients) irradiation. Patients received doses between 25 Gy and 50 Gy (median 35 Gy).
The 5- and 10-year actuarial overall survival rates were 76% and 51%. Relapse free survival was 62% and 48% respectively. The median follow-up was 4,0 years. Relapses after complete remission were registered in 44 cases. Six patients have had in-field-recurrences. The majority of out-field-recurrences were nodal relapses (50%). 11% of relapses occurred outside of lymph nodes or were disseminated failures (18%). Significant favorable prognostic factors identified by multivariate and univariate analysis were low age (age < 50 years vs. age > 50 years), low stage and performance of bipedal lymphangiography as primary staging procedure.
Radiotherapy is an effective and tolerable treatment modality for follicle centre lymphoma in the early stages I and II. We registered a high proportion of nodal recurrences, which may be minimized by prophylactic extended radiotherapy.
放射治疗是滤泡中心淋巴瘤早期的一种治愈性治疗方式。通过一项回顾性分析对生存率、失败模式和预后因素进行了评估。
1970年至1999年间,德累斯顿有116例I期和II期滤泡中心淋巴瘤患者接受治疗。治疗方式为单纯放疗(103例患者)或放化疗联合(13例患者)。放疗采用受累野照射(IFI,104例患者)、扩大野照射(9例患者)或全淋巴结照射(3例患者)。患者接受的剂量在25 Gy至50 Gy之间(中位剂量35 Gy)。
5年和10年精算总生存率分别为76%和51%。无复发生存率分别为62%和48%。中位随访时间为4.0年。44例患者在完全缓解后复发。6例患者出现野内复发。大多数野外复发为淋巴结复发(50%)。11%的复发发生在淋巴结外或为播散性失败(18%)。多因素和单因素分析确定的显著有利预后因素为低年龄(年龄<50岁与年龄>50岁)、低分期以及将双足淋巴管造影作为主要分期程序。
放射治疗是I期和II期早期滤泡中心淋巴瘤的一种有效且耐受性良好的治疗方式。我们发现淋巴结复发比例较高,通过预防性扩大放疗可能将其降至最低。