Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
Int J Radiat Oncol Biol Phys. 2011 Dec 1;81(5):e781-6. doi: 10.1016/j.ijrobp.2010.10.013. Epub 2010 Dec 16.
The purpose of this study was to assess the efficacy of a 2×2 Gy (total dose, 4 Gy) palliative radiation therapy (RT) regimen for treating patients with indolent non-Hodgkin lymphoma (NHL) in terms of response rate, response duration, and symptom relief.
A retrospective chart review was conducted. Between 2003 and 2007, 54 patients with NHL were treated to 85 anatomical sites with a 2×2 Gy palliative regimen. Local response was assessed by clinical and/or radiographic data. Symptoms before and after treatment for each site treated were obtained from clinical notes in patient medical records. Median follow-up time was 1.3 years.
For the 54 patients, the median age at time of treatment was 71.1 years old, and 57% of them were male. Of the 85 disease sites treated, 56% of sites had indolent histology, 28% of sites were diagnosed with chronic lymphocytic leukemia (CLL), 13% of sites had aggressive histology, and 2% of sites were shown to have other histology. Overall response rate (ORR) was 81% (49% complete response [CR], 32% partial response [PR]). The 2-year rate for freedom from local progression was 50% (95% CI, 37%-61%). The ORR for follicular lymphoma, Mucosa associated lymphoid tissue (MALT), and marginal zone lymphoma (MZL) histology was 88%, compared with a 59% rate for CLL histology (p=0.005). While the ORR was similar for tumors of different sizes, the CR rate for patients with tumors<5 cm tended to be higher than those with tumors>10 cm (CR rate of 57% vs. 27%, respectively; p=0.06). For the 48 sites with clearly documented symptoms at pretreatment, 92% of sites improved after low-dose RT.
Short-course low-dose palliative radiotherapy (2×2 Gy) is an effective treatment that results in high response rates for indolent non-Hodgkin lymphoma. This treatment regimen provides effective symptomatic relief for tumor bulk of all sizes.
本研究旨在评估 2×2 Gy（总剂量 4 Gy）姑息性放疗（RT）方案治疗惰性非霍奇金淋巴瘤（NHL）患者的疗效，包括缓解率、缓解持续时间和症状缓解。
回顾性病历分析。2003 年至 2007 年，54 例 NHL 患者 85 个病灶接受 2×2 Gy 姑息性治疗方案。局部反应通过临床和/或影像学数据进行评估。从患者病历的临床记录中获取每个治疗部位治疗前后的症状。中位随访时间为 1.3 年。
54 例患者的中位治疗年龄为 71.1 岁，57%为男性。85 个治疗病灶中，56%为惰性组织学，28%为慢性淋巴细胞白血病（CLL），13%为侵袭性组织学，2%为其他组织学。总缓解率（ORR）为 81%（完全缓解[CR]49%，部分缓解[PR]32%）。2 年无局部进展率为 50%（95%CI，37%-61%）。滤泡性淋巴瘤、黏膜相关淋巴组织（MALT）和边缘区淋巴瘤（MZL）组织学的 ORR 为 88%，而 CLL 组织学的 ORR 为 59%（p=0.005）。不同大小肿瘤的 ORR 相似，但肿瘤<5cm 的患者 CR 率高于肿瘤>10cm 的患者（CR 率分别为 57%和 27%；p=0.06）。在 48 个治疗前有明确症状的病灶中，92%的病灶在接受低剂量 RT 后得到改善。
短程低剂量姑息性放疗（2×2 Gy）是一种有效的治疗方法，可使惰性非霍奇金淋巴瘤的缓解率高。该治疗方案对所有大小的肿瘤肿块均能有效缓解症状。
