Cha Hyejung, Kim Jun Won, Suh Chang-Ok, Kim Jin Seok, Cheong June-Won, Lee Jeongshim, Keum Ki Chang, Lee Chang Geol, Cho Jaeho
Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Radiat Oncol J. 2013 Dec;31(4):177-84. doi: 10.3857/roj.2013.31.4.177. Epub 2013 Dec 31.
The aim of this study was to analyze the patterns of care and treatment outcomes in patients with primary thyroid lymphoma (PTL) in a single institution.
Medical records of 29 patients with PTL treated between April 1994 and February 2012 were retrospectively reviewed. Diagnosis was confirmed by biopsy (n = 17) or thyroidectomy (n = 12). Treatment modality and outcome were analyzed according to lymphoma grade.
The median follow-up was 43.2 months (range, 3.8 to 220.8 months). The median age at diagnosis was 57 years (range, 21 to 83 years) and 24 (82.8%) patients were female. Twenty-five (86.2%) patients had PTL with stage IEA and IIEA. There were 8 (27.6%) patients with mucosa-associated lymphoid tissue (MALT) lymphoma and the remaining patients had high-grade lymphoma. Patients were treated with surgery (n = 2), chemotherapy (n = 7), radiotherapy (n = 3) alone, or a combination of these methods (n = 17). Treatment modalities evolved over time and a combination of modalities was preferred, especially for the treatment of high-grade lymphoma in recent years. There was no death or relapse among MALT lymphoma patients. Among high-grade lymphoma patients, 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 75.6% and 73.9%, respectively. Complete remission after initial treatment was the only significant prognostic factor for OS (p = 0.037) and PFS (p = 0.003).
Patients with PTL showed a favorable outcome, especially with MALT lymphoma. Radiotherapy alone for MALT lymphoma and chemotherapy followed by radiotherapy for high-grade lymphoma can be effective treatment options for PTL.
本研究旨在分析单一机构中原发性甲状腺淋巴瘤(PTL)患者的治疗模式及治疗结果。
回顾性分析1994年4月至2012年2月间接受治疗的29例PTL患者的病历。通过活检(n = 17)或甲状腺切除术(n = 12)确诊。根据淋巴瘤分级分析治疗方式及结果。
中位随访时间为43.2个月(范围3.8至220.8个月)。诊断时的中位年龄为57岁(范围21至83岁),24例(82.8%)为女性。25例(86.2%)患者的PTL为IEA期和IIEA期。8例(27.6%)患者为黏膜相关淋巴组织(MALT)淋巴瘤,其余患者为高级别淋巴瘤。患者接受单独手术治疗(n = 2)、化疗(n = 7)、放疗(n = 3)或这些方法的联合治疗(n = 17)。治疗方式随时间演变,联合治疗方式更受青睐,尤其是近年来对高级别淋巴瘤的治疗。MALT淋巴瘤患者无死亡或复发。在高级别淋巴瘤患者中,5年总生存率(OS)和5年无进展生存率(PFS)分别为75.6%和73.9%。初始治疗后完全缓解是OS(p = 0.037)和PFS(p = 0.003)的唯一显著预后因素。
PTL患者显示出良好的治疗结果,尤其是MALT淋巴瘤患者。MALT淋巴瘤单独放疗以及高级别淋巴瘤化疗后放疗可能是PTL的有效治疗选择。