Li X, Ye J, Yang L, Wei L Q, Cong J, Yao N, Yang J, Wang J W
Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Xue Ye Xue Za Zhi. 2022 Mar 14;43(3):209-214. doi: 10.3760/cma.j.issn.0253-2727.2022.03.005.
This study aimed to see how different initial treatment regimens affected the long-term prognosis of patients with extranodal marginal zone mucosa-associated lymphoid tissue lymphoma confining to the ocular adnexal (OAML) . Between April 2008 and April 2019, 109 patients with initial mucosa-associated lymphoid tissue confining to ocular adnexal were evaluated and followed-up, and the prognosis of various initial treatment regimens were examined. A total of 36 patients underwent complete surgical resection of the lesions, and 73 patients had residual lesions after surgery, of which 37 patients chose watchful waiting, and 36 patients chose treatment. The treatment regimen included local radiotherapy and systemic treatment (chemotherapy, immunochemotherapy, the combination of radiotherapy and chemotherapy, etc.) , and no serious toxic and side effects were observed in patients receiving systemic treatment. The median follow-up time was 61 (10-142) months. The 5-year and 10-year progression-free survival (PFS) of monocular involvement patients were 78.2% and 76.0% . The 5-year and 10-year PFS rates of patients with binocular involvement were 64.4% and 23.5%. There was significant diference in PFS between patients with monocular and binocular involvement (=0.010) . Patients who received additional treatment had higher PFS than those patients in the watchful waiting group (=0.046) . The 5-year PFS was 71.4% and 90.1% among patients in the watchful waiting group and those who received additional treatment, whereas the 10-year PFS was 63.5% and 75.1% , respectively. Patients with OAML were still a risk of disease progression after 5 years. Patients with binocular involvement OAML at the start of the disease had a poor prognosis, but treatment could reduce the risk of recurrence/progression. Systemic therapy is one of the first-line treatment options for patients with OAML, who require long-term monitoring.
本研究旨在观察不同的初始治疗方案如何影响局限于眼附属器的结外边缘区黏膜相关淋巴组织淋巴瘤（OAML）患者的长期预后。2008年4月至2019年4月，对109例初始局限于眼附属器的黏膜相关淋巴组织患者进行了评估和随访，并检查了各种初始治疗方案的预后。共有36例患者接受了病变的完整手术切除，73例患者术后有残留病变，其中37例患者选择观察等待，36例患者选择治疗。治疗方案包括局部放疗和全身治疗（化疗、免疫化疗、放疗与化疗联合等），接受全身治疗的患者未观察到严重的毒副作用。中位随访时间为61（10 - 142）个月。单眼受累患者的5年和10年无进展生存率（PFS）分别为78.2%和76.0%。双眼受累患者的5年和10年PFS率分别为64.4%和23.5%。单眼和双眼受累患者的PFS有显著差异（P = 0.010）。接受额外治疗的患者的PFS高于观察等待组的患者（P = 0.046）。观察等待组和接受额外治疗的患者的5年PFS分别为71.4%和90.1%，而10年PFS分别为63.5%和75.1%。OAML患者在5年后仍有疾病进展的风险。疾病开始时双眼受累的OAML患者预后较差，但治疗可降低复发/进展风险。全身治疗是OAML患者的一线治疗选择之一，这类患者需要长期监测。
