Hayabuchi N, Jingu K, Miyoshi M, Akasi Y, Masuda K, Komiyama S, Kikuchi M
Department of Radiology, Saga Medical School, Kyushu University.
Nihon Gan Chiryo Gakkai Shi. 1990 Jul 20;25(7):1428-36.
Sixty-four patients with stages I and II non-Hodgkin's lymphomas (NHL) involving Waldeyer's ring treated between 1970 and 1987 were reviewed. Patients with stage II NHL were subdivided into stage II 1 (limited type) and stage II2 (advanced type) from the state of neck nodes. Stage II1 was defined as involvement of unilateral cervical nodes less than 4 cm in diameter as well as Waldeyer's ring involvement. Other stage II cases were classified as stage II2. All 17 patients with stage I NHL were treated with radiation therapy alone. Their diseases were well controlled, and none of them died of causes related to the lymphoma. Among 14 patients with stage II1 NHL, the 5-year survival rate for the 9 patients treated with radiation therapy alone was 87.5%. Until 1982, 19 of 21 patients with stage II2 NHL treated with radiation therapy alone or radiation therapy and adjuvant chemotherapy (VEMP or COPP) died within 5 years mainly of disseminated diseases. Since 1983, CHOP has been used as the main treatment as well as radiotherapy for the 12 stage II2 NHL patients. So far, only 3 of them relapsed and 2 of them died of causes related to the lymphoma. Only 1 of these 12 patients was T-cell lymphoma compared to 7 of 9 stage II2 patients before 1982. This suggests that patients with stage I and those with limited stage II can be safely treated with radiotherapy. Also aggressive chemotherapy as well as radiotherapy should be used for patients with advanced stage II NHL involving Waldeyer's ring.
对1970年至1987年间接受治疗的64例累及韦氏环的Ⅰ期和Ⅱ期非霍奇金淋巴瘤（NHL）患者进行了回顾性研究。根据颈部淋巴结状态，将Ⅱ期NHL患者细分为Ⅱ1期（局限型）和Ⅱ2期（进展型）。Ⅱ1期定义为单侧直径小于4 cm的颈部淋巴结受累以及韦氏环受累。其他Ⅱ期病例归类为Ⅱ2期。所有17例Ⅰ期NHL患者均仅接受放射治疗。他们的疾病得到了很好的控制，无一例死于与淋巴瘤相关的原因。在14例Ⅱ1期NHL患者中，9例仅接受放射治疗的患者5年生存率为87.5%。直到1982年，21例仅接受放射治疗或放射治疗加辅助化疗（VEMP或COPP）的Ⅱ2期NHL患者中有19例在5年内死亡，主要死于播散性疾病。自1983年以来，CHOP一直作为主要治疗方法以及放疗用于12例Ⅱ2期NHL患者。到目前为止，他们中只有3例复发，2例死于与淋巴瘤相关的原因。这12例患者中只有1例是T细胞淋巴瘤，而1982年前9例Ⅱ2期患者中有7例是T细胞淋巴瘤。这表明Ⅰ期患者和局限的Ⅱ期患者可以安全地接受放射治疗。对于累及韦氏环的晚期Ⅱ期NHL患者，也应采用积极的化疗以及放疗。
