Guadagnolo Beverly A, Li Sigui, Neuberg Donna, Ng Andrea, Hua Ling, Silver Barbara, Stevenson Mary Ann, Mauch Peter
Joint Center for Radiation Therapy/Harvard Radiation Oncology Residency Program, Boston, MA, USA.
Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):928-34. doi: 10.1016/j.ijrobp.2005.08.010. Epub 2005 Oct 21.
To analyze long-term outcomes and causes of death in patients receiving radiation therapy (RT) for localized, low-grade follicular lymphoma.
Between 1972 and 2000, 106 patients with Stage I-II, Grade 1-2 follicular lymphoma received RT alone or radiation and chemotherapy (RT/CT). Seventy-four percent had Stage I, and 26% had Stage II disease. Seventy-six percent received RT alone, and 24% received combined RT/CT. Second malignancy rates were compared with an age- and sex-matched population.
Median follow-up was 12 years. Median survival time was 19 years. The 5-, 10-, and 15-year overall survival (OS) rates were 93%, 75%, and 62%, respectively. Age > or = 60 was the only significant adverse prognostic factor with respect to OS. There were 35 deaths, 20 of which were attributable to lymphoma. Freedom from treatment failure (FFTF) rates at 5, 10, and 15 years were 72%, 46%, and 39%, respectively. Forty-seven patients (48%) relapsed. Tumor size > 3 cm was the only significant adverse factor for FFTF. Observed incidence of second malignancy did not significantly exceed expected incidence.
Although patients with early-stage, low-grade follicular lymphoma have long median survival, the leading cause of death remains lymphoma. However, patients receiving RT do not have significantly elevated cumulative incidence of second malignancy.
分析接受放射治疗（RT）的局限性、低级别滤泡性淋巴瘤患者的长期预后及死亡原因。
1972年至2000年间，106例I-II期、1-2级滤泡性淋巴瘤患者单独接受放疗或放疗联合化疗（RT/CT）。74%为I期，26%为II期。76%单独接受放疗，24%接受RT/CT联合治疗。将第二原发恶性肿瘤发生率与年龄和性别匹配的人群进行比较。
中位随访时间为12年。中位生存时间为19年。5年、10年和15年总生存率（OS）分别为93%、75%和62%。年龄≥60岁是OS唯一显著的不良预后因素。共有35例死亡，其中20例归因于淋巴瘤。5年、10年和15年无治疗失败生存率（FFTF）分别为72%、46%和39%。47例患者（48%）复发。肿瘤大小>3 cm是FFTF唯一显著的不良因素。观察到的第二原发恶性肿瘤发生率未显著超过预期发生率。
尽管早期、低级别滤泡性淋巴瘤患者的中位生存期较长，但主要死亡原因仍是淋巴瘤。然而，接受放疗的患者第二原发恶性肿瘤的累积发生率并未显著升高。
