Department of Endoscopy, Okayama University Hospital, Okayama, Japan.
Digestion. 2012;86(3):179-86. doi: 10.1159/000339497. Epub 2012 Aug 16.
BACKGROUND/AIMS: Few studies exist on the efficacy and long-term outcome of radiation therapy (RT) for gastric mucosa-associated lymphoid tissue (MALT) lymphoma.
Twenty-two patients with stage I or stage II(1) disease were prospectively evaluated, including 14 patients without Helicobacter pylori(H. pylori) infection and 8 patients with persistent lymphoma after H. pylori eradication. RT dose was 30 Gy in daily fractions of 1.5 Gy. All patients underwent endoscopic and histological follow-up regularly.
The study included 22 patients with a mean age of 63 years. The t(11;18)(q21;q21) translocation occurred in 8 of the 22 cases. All patients showed complete remission without any serious toxicity. At a median follow-up evaluation 74 months (range 27-159) after completion of RT, the overall and relapse-free survival rates after 5 years were 91 and 84%, respectively. Although no patient showed local recurrence of lymphoma, distant recurrence was detected in 3 patients, all of whom were H. pylori negative; MALT lymphoma relapsed in two patients with the t(11;18)(q21;q21) translocation, and diffuse large-cell lymphoma developed in one patient without the translocation.
RT provides excellent local control of the gastric MALT lymphoma. However, continuous follow-up is mandatory as relapse may occur in other sites.
背景/目的：关于胃黏膜相关淋巴组织（MALT）淋巴瘤的放射治疗（RT）的疗效和长期结果的研究很少。
前瞻性评估了 22 例 I 期或 II 期（1）疾病患者，包括 14 例无幽门螺杆菌（H. pylori）感染和 8 例 H. pylori 根除后持续存在淋巴瘤的患者。RT 剂量为 30 Gy，每日 1.5 Gy 分次。所有患者均定期进行内镜和组织学随访。
该研究包括 22 例平均年龄为 63 岁的患者。22 例中有 8 例发生 t（11;18）（q21;q21）易位。所有患者均无严重毒性完全缓解。在 RT 完成后中位随访 74 个月（范围 27-159）时，5 年后总生存率和无复发生存率分别为 91%和 84%。尽管没有患者出现淋巴瘤局部复发，但在 3 例患者中检测到远处复发，均为 H. pylori 阴性；t（11;18）（q21;q21）易位的 2 例患者中 MALT 淋巴瘤复发，1 例无易位的患者中发生弥漫大细胞淋巴瘤。
RT 为胃 MALT 淋巴瘤提供了极好的局部控制。然而，必须进行持续随访，因为可能在其他部位复发。
