Rahal M, Cosset J M, Richard J M, Bosq J, Girinski T, Schwaab G, Hayat M, Amiel J L
Ann Otolaryngol Chir Cervicofac. 1987;104(1):9-13.
Twenty-four patients with non Hodgkin's lymphoma of nasopharynx were treated in the Institut Gustave-Roussy, France, between 1976 and 1983. Mean age of patients was 53 years and the male/female sex ratio was 2. Symptomatology was immediately suggestive of a lesion in the nasopharynx in 21 of the 24 patients, and histology gave an unfavorable prognosis (diffuse large cell tumors) in 71% of cases. Complete investigations showed the lymphoma to be relatively limited in extent in the majority of cases (68% of stages I and II). These findings are in agreement with published reports. The 4 patient with stage I disease were treated by irradiation alone and are all alive without recurrence after 43 months. The 11 patients with stage II lesions received combined chemo-radiotherapy, and at 42-month follow up 8 were alive without recurrence (1 patient died of intercurrent illness). Results of conventional chemotherapy (CHVmP) in patients with stages III and IV were disappointing, however: only one patient survived for 60 months (after a cerebral recurrence treated by irradiation). Although current therapy is effective for stage I and II lesions, patients with stages III and IV require more aggressive therapy recently developed: heavy multiple chemotherapy, and even intensive chemotherapy-total body irradiation and bone marrow graft.
1976年至1983年间,法国古斯塔夫 - 鲁西研究所对24例鼻咽非霍奇金淋巴瘤患者进行了治疗。患者的平均年龄为53岁,男女比例为2。24例患者中有21例的症状立即提示鼻咽部有病变,71%的病例组织学显示预后不良(弥漫性大细胞肿瘤)。全面检查显示,大多数病例(68%为I期和II期)的淋巴瘤范围相对局限。这些发现与已发表的报告一致。4例I期疾病患者仅接受了放疗,43个月后均存活且无复发。11例II期病变患者接受了化疗联合放疗,在42个月的随访中,8例存活且无复发(1例死于并发疾病)。然而,III期和IV期患者的传统化疗(CHVmP)结果令人失望:只有1例患者存活了60个月(脑部复发后接受放疗)。尽管目前的治疗方法对I期和II期病变有效,但III期和IV期患者需要更积极的最新治疗方法:强烈的多重化疗,甚至是强化化疗 - 全身照射和骨髓移植。