Koh Myeong Seok, Kim Won Seog, Kim Seok Jin, Oh Sung Yong, Yoon Dok Hyun, Lee Soon Il, Hong Junshik, Song Moo Kon, Shin Ho-Jin, Kwon Jung Hye, Kim Hyo Jung, Do Yong Rok, Suh Cheolwon, Kim Hyo Jin
Department of Internal Medicine, Dong-A University College of Medicine, Daeshin Park road 26, Seo-gu, Pusan, 602-715, Korea.
Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Int J Hematol. 2015 Oct;102(4):420-5. doi: 10.1007/s12185-015-1845-6. Epub 2015 Jul 26.
Even though local stage (Ann Arbor stage I/II) marginal zone lymphoma (MZL) is well controlled with local treatment-based therapy, no data exist on the role of additional chemotherapy after local treatment for stage I/II MZL. Patients with biopsy-confirmed Ann Arbor stage I/II MZL (n = 210) were included for analysis in this study. Of these, 180 patients (85.7 %) were stage I and 30 (14.3 %) were stage II. Most patients (n = 182, 86.7 %) were treated with a local modality including radiation therapy or surgery and 28 (13.3 %) received additional systemic chemotherapy after local treatment. The overall response rate was 98.3 % (95 % CI 96-100 %), with 187 complete responses and 20 partial responses. In the local treatment group, the mean progression-free survival (PFS) was 147.4 months (95 % CI 126.7-168.1 months) and the overall survival (OS) was 188.2 months (95 % CI 178.8-197.7 months). In the additional chemotherapy group, the mean PFS was 103.4 months (95 % CI 84.9-121.9 months) and the OS was 137.3 months (95 % CI 127.9-146.7 months). There was no difference between the two groups in OS (p = 0.836) and PFS (p = 0.695). Local stage MZL has a good clinical course and is well controlled with a local treatment modality without additional chemotherapy.
尽管局限性分期(Ann Arbor分期I/II期)的边缘区淋巴瘤(MZL)通过基于局部治疗的疗法能得到很好的控制,但关于I/II期MZL局部治疗后加用化疗的作用尚无数据。本研究纳入经活检确诊确诊的Ann Arbor分期I/II期MZL的患者(n = 210)进行分析。其中,180例患者(85.7%)为I期,30例(14.3%)为II期。大多数患者(n = 182,86.7%)接受了包括放疗或手术在内的局部治疗方式,28例(13.3%)在局部治疗后接受了额外的全身化疗。总缓解率为98.3%(95%CI 96 - 100%),其中187例完全缓解,20例部分缓解。在局部治疗组中,平均无进展生存期(PFS)为147.4个月(95%CI 126.7 - 168.1个月),总生存期(OS)为188.2个月(95%CI 178.8 - 197.7个月)。在加用化疗组中,平均PFS为103.4个月(95%CI 84.9 - 121.9个月),OS为137.3个月(95%CI 127.9 - 146.7个月)。两组在OS(p = 0.836)和PFS(p = 0.695)方面无差异。局限性分期的MZL具有良好的临床病程,通过局部治疗方式无需加用化疗即可得到很好的控制。