Hall Matthew D, Chen Yi-Jen, Schultheiss Timothy E, Pezner Richard D, Stein Anthony S, Wong Jeffrey Y C
Department of Radiation Oncology, City of Hope National Medical Cancer, Duarte, California, USA.
J Med Imaging Radiat Oncol. 2014 Aug;58(4):523-7. doi: 10.1111/1754-9485.12172. Epub 2014 Mar 20.
This study aims to analyse treatment outcomes, disease control and toxicity in patients with chloromas referred for radiation therapy (RT).
Medical records were retrospectively reviewed for 41 patients with chloromas treated with RT at our institution.
Twenty-five patients were treated with palliative intent, whereas sixteen received RT as a component of curative intent therapy in addition to systemic chemotherapy with or without haematopoietic stem cell transplant (HSCT). All patients received RT for chloroma (median dose 24 Gy). Median survival was 5.4 months after RT (95% confidence interval (CI) 3.5-12.6 months), and no significant difference in overall survival was identified based on prior treatment with systemic chemotherapy alone or HSCT. Patients treated with curative intent had a median survival of 26.2 months (95% CI 6.1-48.9 months) and a Kaplan-Meier estimate of 15% overall survival at 5 years. At the end of the study follow-up period, 38 patients were dead and three patients treated with curative intent remained alive. After palliative RT, 44% of patients experienced partial relief and 48% experienced complete symptomatic improvement without significant acute toxicities.
RT provides timely symptom palliation for patients with chloromas with minimal morbidity, but the prognosis remains poor. Long-term remission can be achieved in selected patients with salvage chemotherapy and HSCT.
本研究旨在分析接受放射治疗（RT）的绿色瘤患者的治疗结果、疾病控制情况及毒性反应。
对在我院接受RT治疗的41例绿色瘤患者的病历进行回顾性分析。
25例患者接受姑息性治疗，16例除接受有或无造血干细胞移植（HSCT）的全身化疗外，还接受RT作为根治性治疗的一部分。所有患者均接受针对绿色瘤的RT治疗（中位剂量24 Gy）。RT治疗后中位生存期为5.4个月（95%置信区间[CI] 3.5 - 12.6个月），基于单纯既往全身化疗或HSCT治疗，未发现总生存期有显著差异。接受根治性治疗的患者中位生存期为26.2个月（95% CI 6.1 - 48.9个月），5年总生存率的Kaplan-Meier估计值为15%。在研究随访期结束时，38例患者死亡，3例接受根治性治疗的患者仍存活。姑息性RT治疗后，44%的患者症状部分缓解，48%的患者症状完全改善，且无明显急性毒性反应。
RT可为绿色瘤患者及时缓解症状，且发病率极低，但预后仍然较差。部分患者通过挽救性化疗和HSCT可实现长期缓解。
