Raina Vinod, Sharma Atul, Vora Amish, Shukla N K, Deo S V S, Dawar R
Departments of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Indian J Cancer. 2006 Jan-Mar;43(1):30-5. doi: 10.4103/0019-509x.25773.
Gastrointestinal tract (GI) is the most frequently involved extra nodal site in non-Hodgkin's lymphoma (NHL). Surgery, radiotherapy and chemotherapy (CT) have been used mostly in various combinations, but lately chemotherapy alone has emerged as an effective option. The purpose of this study is to evaluate efficacy of CT alone in treatment of primary GI-NHL and to compare the results with combined CT+surgery.
Retrospective analysis of case records of GI NHL patients.
Over a 15-year period (1986-2000), 77 new cases of primary GI-NHL were registered at our center. GI-NHL was defined according to standard criteria. All patients received chemotherapy.
The median age was 32 years (Range 9-80). Endoscopy / CT guided biopsies were performed in 42% (32) of patients for the purpose of diagnosis. Laparotomy was done in 58% (45) of patients to establish a diagnosis or as primary or debulking treatment. Stomach and intestines were involved in 47% (36) and 53% (41) patients respectively. Early stage disease was present in 37% (29). Seventy eight percent of tumors were intermediate to high grade, 43% (33) received only CT while 57% (44) received CT+surgery. Five years EFS and OS were: 72% and 65% for all patients; 72% and 67% for CT only group; 60% and 64% for CT+surgery group (P=.05). Four patients died of neutropenic infection.
Organ-preservation strategy using chemotherapy alone (CT) can be successfully employed in a significant number of patients with primary GI-NHL.
胃肠道（GI）是非霍奇金淋巴瘤（NHL）最常累及的结外部位。手术、放疗和化疗（CT）大多以各种组合方式使用，但最近单纯化疗已成为一种有效的选择。本研究的目的是评估单纯化疗治疗原发性胃肠道NHL的疗效，并将结果与化疗联合手术进行比较。
对胃肠道NHL患者的病例记录进行回顾性分析。
在15年期间（1986 - 2000年），我们中心登记了77例原发性胃肠道NHL新病例。根据标准标准定义胃肠道NHL。所有患者均接受化疗。
中位年龄为32岁（范围9 - 80岁）。42%（32例）患者接受了内镜/CT引导下活检以进行诊断。58%（45例）患者进行了剖腹手术以明确诊断或作为主要或减瘤治疗。胃和肠道分别累及47%（36例）和53%（41例）患者。37%（29例）为早期疾病。78%的肿瘤为中高级别，43%（33例）仅接受化疗，57%（44例）接受化疗+手术。所有患者的5年无事件生存率（EFS）和总生存率（OS）分别为72%和65%；单纯化疗组为72%和67%；化疗+手术组为60%和64%（P = 0.05）。4例患者死于中性粒细胞减少性感染。
对于大量原发性胃肠道NHL患者，单独使用化疗（CT）的器官保留策略可成功应用。
