Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
Wills Eye Hospital, Philadelphia, Pennsylvania.
Ophthalmology. 2018 Jan;125(1):127-136. doi: 10.1016/j.ophtha.2017.05.037. Epub 2017 Jul 14.
To review the literature to determine the efficacy of available treatments for ocular adnexal lymphoma (OAL) and to evaluate the outcomes and complications of treatments in patients older than 13 years.
A literature search was conducted last in March 2017 in the PubMed and Cochrane Library databases for English-language original research investigations that evaluated treatment outcomes for OAL. The searches identified 307 unique citations, and 27 studies were selected according to the criteria outlined for this assessment.
The 27 studies reviewed comprised 2009 patients. Seventy-five percent of the cases reported were extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT). Twenty-five studies reported results using radiotherapy with or without chemotherapy or surgery. The local control rate of MALT lymphomas with treatments involving radiotherapy averaged 95.9%. Distant and local relapses can occur, and in studies reporting only on MALT lymphomas (884 patients), the 5-year and 10-year disease-free survival rates were reported to be 86.4% and 78.7%, respectively. However, overall survival in patients receiving radiotherapy remained very good, with the 5-year and 10-year survival rates reported to be 93.8% and 84.9%, respectively. Studies that included data on multiple histologic subtypes of lymphoma or non-MALT lymphomas (988 patients) reported local control rates to be 93.1%; 5-year and 10-year disease-free survival rates to be 75.7% and 71.0%, respectively; and 5-year and 10-year overall survival rates to be 78.9% and 73.5%, respectively. Studies on the use of doxycycline for MALT lymphomas (137 patients) reported complete responses of between 4.4% and 13%. Complete and partial responses combined were between 26.7% and 65%. Disease-free survival was not reported for these 2 studies, although progression-free survival was reported to be between 55% and 60.9%. The most frequently reported complications of treatment were cataracts (12.1%) and dry eye (8.5%).
For MALT lymphomas, local control, disease-free survival, and overall survival are good with radiation treatment. The results of treatment of non-MALT lymphomas using radiotherapy also were good, but they were not as favorable as the treatment results of MALT lymphomas.
回顾文献，确定现有的眼附属器淋巴瘤（OAL）治疗方法的疗效，并评估 13 岁以上患者治疗的结果和并发症。
2017 年 3 月，我们在 PubMed 和 Cochrane 图书馆数据库中对评估 OAL 治疗结果的英文原始研究调查进行了文献检索。检索共确定了 307 个独特的引文，根据本评估概述的标准选择了 27 项研究。
27 项研究共纳入 2009 例患者。报告的病例中，75%为黏膜相关淋巴组织结外边缘区淋巴瘤（MALT）。25 项研究报告了放疗联合或不联合化疗或手术的结果。涉及放疗的 MALT 淋巴瘤的局部控制率平均为 95.9%。可能会出现远处和局部复发，在仅报告 MALT 淋巴瘤（884 例患者）的研究中，5 年和 10 年无疾病生存率分别报告为 86.4%和 78.7%。然而，接受放疗的患者的总体生存率仍然很好，5 年和 10 年生存率分别报告为 93.8%和 84.9%。纳入多种淋巴瘤组织学亚型或非 MALT 淋巴瘤数据的研究（988 例患者）报告的局部控制率为 93.1%；5 年和 10 年无疾病生存率分别为 75.7%和 71.0%；5 年和 10 年总生存率分别为 78.9%和 73.5%。2 项关于多西环素治疗 MALT 淋巴瘤（137 例患者）的研究报告完全缓解率为 4.4%至 13%。完全缓解和部分缓解合并率为 26.7%至 65%。这两项研究未报告无疾病生存率，但报告无进展生存率为 55%至 60.9%。治疗最常报告的并发症是白内障（12.1%）和干眼症（8.5%）。
对于 MALT 淋巴瘤，放疗的局部控制、无病生存率和总生存率良好。非 MALT 淋巴瘤的放疗治疗结果也很好，但不如 MALT 淋巴瘤的治疗结果好。
