结膜黏膜相关淋巴组织（MALT）淋巴瘤患者的治疗结果
Treatment Outcomes in Patients with Conjunctival Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma.
作者信息
Matsuo Yu, Monden Yu, Sasaki Kensuke, Akune Hodaka, Ikeda Shuntaro, Ishio Daiki, Murotani Kenta, Nagafuji Koji, Yoshida Shigeo
机构信息
Department of Ophthalmology, Kurume University School of Medicine, Kurume, Japan.
Biostatistics Center, Kurume University, Kurume, Japan.
出版信息
Clin Ophthalmol. 2024 Jul 10;18:1999-2007. doi: 10.2147/OPTH.S463653. eCollection 2024.
PURPOSE
To report the outcomes of different therapies in patients with conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma.
PATIENTS AND METHODS
This retrospective study included patients diagnosed with conjunctival MALT lymphoma between August 2000 and April 2022. Patients were classified into three groups according to their treatment: an observation group, a radiation therapy (RT) group, and a rituximab group (rituximab with or without chemotherapy). We analyzed overall survival (OS), overall, local, and systemic relapse-free survival (RFS), and adverse events after treatment.
RESULTS
This study included 15 patients (22 eyes). The 10-year OS was 100%. The 2-, 5-, and 10-year overall RFS rates were 80.1%, 41.2%, and 41.2% in all patients, respectively. The 2- and 5-year local RFS rates in the observation group were 100% and 0%, respectively. The 2-, 5-, and 10-year local RFS rates were 87%, 87%, and 87% in the RT group and 83%, 67%, and 67% in the rituximab group, respectively. The 2- and 5-year systemic RFS rates in the observation group were both 100%, and the 2-, 5-, and 10-year systemic RFS rates were 92%, 55%, and 55% in the RT group, and 100%, 60%, and 60% in the rituximab group, respectively. After RT, 53.3% of the eyes developed cataracts and 75% of these were treated with cataract surgery. In addition, 53.3% of the eyes developed dry eyes and were treated with eye drops. Rituximab with or without chemotherapy resulted in some systemic adverse events, but these improved following symptomatic therapies.
CONCLUSION
RT resulted in good local control of conjunctival MALT lymphoma; however, systemic relapse may occur during long-term follow-up. Local and/or systemic relapse may also occur during long-term follow-up in patients treated by observation or rituximab with or without chemotherapy. Patients with conjunctival MALT lymphoma should be followed-up carefully for as long as possible after treatment.
目的
报告结膜黏膜相关淋巴组织（MALT）淋巴瘤患者不同治疗方法的疗效。
患者与方法
这项回顾性研究纳入了2000年8月至2022年4月期间诊断为结膜MALT淋巴瘤的患者。根据治疗方法将患者分为三组：观察组、放射治疗（RT）组和利妥昔单抗组（利妥昔单抗联合或不联合化疗）。我们分析了总生存期（OS）、总体、局部和全身无复发生存期（RFS）以及治疗后的不良事件。
结果
本研究纳入了15例患者（22只眼）。10年总生存期为100%。所有患者的2年、5年和10年总体无复发生存率分别为80.1%、41.2%和41.2%。观察组的2年和5年局部无复发生存率分别为100%和0%。RT组的2年、5年和10年局部无复发生存率分别为87%、87%和87%，利妥昔单抗组分别为83%、67%和67%。观察组的2年和5年全身无复发生存率均为100%，RT组的2年、5年和10年全身无复发生存率分别为92%、55%和55%；利妥昔单抗组分别为100%、60%和60%。放疗后，53.3%的眼睛出现白内障，其中75%接受了白内障手术治疗。此外，53.3%的眼睛出现干眼症并接受了滴眼液治疗。利妥昔单抗联合或不联合化疗导致了一些全身不良事件，但经对症治疗后有所改善。
结论
放疗对结膜MALT淋巴瘤有良好的局部控制效果；然而，在长期随访期间可能会发生全身复发。接受观察或利妥昔单抗联合或不联合化疗治疗的患者在长期随访期间也可能发生局部和/或全身复发。结膜MALT淋巴瘤患者治疗后应尽可能长时间进行密切随访。
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