Vural Filiz, Cagirgan Seckin, Saydam Guray, Hekimgil Mine, Soyer Nur Akad, Tombuloglu Murat
Ege University, Faculty of Medicine, Hematology Department, 35100 Bornova, Izmir.
J Natl Med Assoc. 2007 Nov;99(11):1277-82.
We evaluated clinical features, management and survival of 12 patients with primary testicular non-Hodgkin's lymphoma presented to our hematology unit between January 1992 and July 2006, retrospectively. The median age of patients was 47 years at presentation (range 29-78 years) and > 80% of them were < 50 years old. In the majority of cases, orchidectomy was performed as diagnostic and first-line therapeutic procedures. Dominant histological subtype was diffuse large B-cell non-Hodgkin's lymphoma. Seven patients out of 12 (58%) were Ann Arbor stages I and II, and the remaining five patients (42%) were stages III and IV. All the patients received doxorubicin-based chemotherapy and achieved complete remission. The addition of rituximab and central nervous system prophylaxis with intrathecal combined chemotherapy containing methotrexate, cytarabine and dexametasone were applied to three patients who were recently admitted. The rate of relapse was 8% and progression-free survival (PFS) at 10 years was 88%. Median duration of response was 84 months (range 14-173 months), median 97.5 months of follow-up. All patients are alive and in case remission. Because of the spreading nature and relapse probability at different sites, including central nervous system and contralateral testis, systemic treatment with doxorubicin-based chemotherapy with or without prophylaxis for contralateral testis and the central nervous system seems to improve the outcome of primary testicular lymphoma.
我们回顾性评估了1992年1月至2006年7月间收治于我院血液科的12例原发性睾丸非霍奇金淋巴瘤患者的临床特征、治疗及生存情况。患者就诊时的中位年龄为47岁(范围29 - 78岁),其中超过80%的患者年龄小于50岁。在大多数病例中,睾丸切除术作为诊断及一线治疗手段实施。主要组织学亚型为弥漫大B细胞非霍奇金淋巴瘤。12例患者中有7例(58%)为Ann Arbor分期I期和II期,其余5例(42%)为III期和IV期。所有患者均接受了以阿霉素为基础的化疗并实现完全缓解。最近收治的3例患者加用了利妥昔单抗,并采用含甲氨蝶呤、阿糖胞苷和地塞米松的鞘内联合化疗进行中枢神经系统预防。复发率为8%,10年无进展生存率(PFS)为88%。中位缓解持续时间为84个月(范围14 - 173个月),中位随访时间97.5个月。所有患者均存活且处于缓解状态。由于原发性睾丸淋巴瘤具有扩散性及不同部位(包括中枢神经系统和对侧睾丸)的复发可能性,采用以阿霉素为基础的全身化疗,无论是否对侧睾丸及中枢神经系统进行预防,似乎都能改善原发性睾丸淋巴瘤的治疗效果。