Department of Internal Medicine, Dong-A University Hospital, Busan, South Korea.
Department of Medicine, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, South Korea.
Ann Hematol. 2018 Oct;97(10):1851-1857. doi: 10.1007/s00277-018-3387-5. Epub 2018 Jun 11.
Both-side synchronous involvement has been reported to account for 7-24% of ocular adnexal marginal zone lymphoma (OAML). We conducted a retrospective analysis to identify the clinical features and treatment outcomes of synchronous bilateral OAML (SB-OAML) by treatment modality. We analyzed patients with a histologic diagnosis of SB-OAML, excluding metachronous bilateral involved OAML. We enrolled a total of 95 patients for this analysis, 36 males and 59 females; the median patient age was 42 years (range 16-77 years). Eleven (11.6%) patients had been treated with chemotherapy or chemo-immunotherapy (eight R-CVP, two CVP, and one R-CHOP). The median number of treatments was 6 (range 6-8); there were 9 complete responses (CRs; 81.8%) and 2 partial responses (PRs; 18.2%). Nearly all patients (88.4%) received radiotherapy in both eyes, and the median radiation dose was 27 Gy (range 20-40 Gy) to each eye; 68 CRs (80.9%) and 14 PRs (16.7%) were achieved. Ten-year progression-free survival (PFS) and overall survival (OS) rates were 79.8 and 91.1%, respectively. Radiotherapy continued to be an independent prognostic marker, with the hazard of progression (P = 0.036). Eleven patients (13.1%) had surgery for cataract treatment during follow-up, and patients who received low-dose radiation (< 30.3 Gy) experienced fewer cataract operations. SB-OAML was predominantly observed in young females, and they had good response and prognosis regardless of treatment modalities. Low-dose radiotherapy to both eyes showed a tendency of longer PFS than did chemotherapy and could decrease cataract operations.
双侧同步受累占眼附属器边缘区淋巴瘤（OAML）的 7-24%。我们通过治疗方式对同步双侧 OAML（SB-OAML）的临床特征和治疗结果进行了回顾性分析。我们分析了组织学诊断为 SB-OAML 的患者，排除了异时性双侧受累的 OAML。共有 95 例患者纳入本分析，其中男 36 例，女 59 例；中位患者年龄为 42 岁（范围 16-77 岁）。11 例（11.6%）患者接受了化疗或化疗免疫治疗（8 例 R-CVP，2 例 CVP，1 例 R-CHOP）。中位治疗次数为 6 次（范围 6-8 次）；9 例完全缓解（CR；81.8%）和 2 例部分缓解（PR；18.2%）。几乎所有患者（88.4%）双眼均接受放疗，双眼中位放疗剂量为 27 Gy（范围 20-40 Gy）；68 例 CR（80.9%）和 14 例 PR（16.7%）。10 年无进展生存（PFS）和总生存（OS）率分别为 79.8%和 91.1%。放疗仍然是独立的预后标志物，进展的风险（P=0.036）。11 例患者（13.1%）在随访期间因白内障治疗而行手术，接受低剂量放疗（<30.3 Gy）的患者手术次数较少。SB-OAML 主要发生于年轻女性，无论治疗方式如何，均有较好的反应和预后。双眼低剂量放疗较化疗有更长的 PFS 趋势，且可减少白内障手术。
