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局限性胃黏膜相关淋巴组织淋巴瘤的放射治疗:超过10年的长期结果

Radiotherapy for localized gastric mucosa-associated lymphoid tissue lymphoma: long-term outcomes over 10 years.

作者信息

Ohkubo Yu, Saito Yoshihiro, Ushijima Hiroki, Onishi Masahiro, Kazumoto Tomoko, Saitoh Jun-Ichi, Kubota Nobuko, Kobayashi Hirofumi, Maseki Nobuo, Nishimura Yu, Kurosumi Masafumi

机构信息

Department of Radiation Oncology, Saitama Cancer Center, 780 Komuro, Ina, kita-adachi, Saitama, 362-0806, Japan.

Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi-shi, Gunma 371-8511, Japan.

出版信息

J Radiat Res. 2017 Jul 1;58(4):537-542. doi: 10.1093/jrr/rrw044.

Abstract

This study aimed to assess the long-term outcomes of radiotherapy in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Twenty-seven patients with Stage I gastric MALT lymphoma were treated with radiotherapy from 1999 to 2010. The median age was 65 years (range: 31-84). Fifteen patients were Helicobacter pylori-negative. Thirteen patients were treated with definitive radiotherapy alone. The other 14 patients who had refractory or residual disease following a prior treatment received salvage radiotherapy. The median dose of the radiotherapy was 30 Gy in 20 fractions (range: 30-39.5 Gy). The median follow-up period was 121 months (range: 8-176 months). The 5- and 10-year overall survival rates for all patients were 92% and 87%, respectively. No patients died from MALT lymphoma. Three patients died of other diseases at 8, 33 and 74 months after radiotherapy (myocardial infarction, pneumonia and hepatocellular carcinoma, respectively). No cases of local recurrence were observed during the follow-up period. There were no serious late gastric, liver or kidney complications during a median follow-up period of over 10 years. Two patients remain alive with distant metastases: a lung metastasis and an abdominal lymph node metastasis at 104 months and 21 months after radiotherapy, respectively. Excellent long-term local control was observed in patients with localized gastric MALT lymphoma after radiotherapy. However, lifelong follow-up should be conducted to detect cases of late recurrence, especially distant metastases.

摘要

本研究旨在评估局限性胃黏膜相关淋巴组织(MALT)淋巴瘤患者放疗的长期疗效。1999年至2010年期间,对27例Ⅰ期胃MALT淋巴瘤患者进行了放疗。中位年龄为65岁(范围:31 - 84岁)。15例患者幽门螺杆菌阴性。13例患者仅接受了根治性放疗。另外14例先前治疗后出现难治性或残留疾病的患者接受了挽救性放疗。放疗的中位剂量为30 Gy,分20次(范围:30 - 39.5 Gy)。中位随访期为121个月(范围:8 - 176个月)。所有患者的5年和10年总生存率分别为92%和87%。无患者死于MALT淋巴瘤。3例患者分别在放疗后8、33和74个月死于其他疾病(分别为心肌梗死、肺炎和肝细胞癌)。随访期间未观察到局部复发病例。在超过10年的中位随访期内,未出现严重的晚期胃部、肝脏或肾脏并发症。2例患者仍存活但有远处转移:分别在放疗后104个月和21个月出现肺转移和腹部淋巴结转移。放疗后局限性胃MALT淋巴瘤患者观察到了出色的长期局部控制。然而,应进行终身随访以检测晚期复发病例,尤其是远处转移。

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