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鼻腔非霍奇金淋巴瘤的放射治疗——附48例报告

[Radiotherapy of non-Hodgkin's lymphoma of the nasal cavity--report of 48 cases].

作者信息

Gu D Z

出版信息

Zhonghua Zhong Liu Za Zhi. 1985 Nov;7(6):460-3.

PMID:3915458
Abstract

From Mar. 1958 through Dec. 1977, a series of 48 patients with Non-Hodgkin's lymphoma in the nasal cavity was treated by radiotherapy in our hospital. The incidence of the disease was only 4.8% (48/983) of all malignant lymphomas during the same interval. The ratio of this tumor with the lymphoma arising for the nasopharynx, tonsil and the base of the tongue is 1:2, 1:3, 9:1. It has an equal chance of locating on the left or right, but was bilateral in 4 patients. In 4, the nasopharynx; 3, the maxillary antrum and 14, the neighboring soft tissues were invaded. The stage IA and IIA lesions as treated by radiotherapy gave 1, 3, 5, 10 and 15 year survival rates of 96%, 82%, 78%, 67% and 44% respectively. Stage IIIA lesions gave a 5 year survival of 25%. All patients with stage IIIB and IV lesions as treated by combination of chemotherapy and radiotherapy died within one year. Those involving the neighboring soft tissues and organs could give a 5 year survival of only 25% and 33%. The prognosis was influenced by the stage and radiation technique. The radiation field must be extensive enough to include the whole nasal cavity (cross the middle line by 1 cm), nasopharyx, the ipsilateral maxillary antrum, hard palate and the regional lymphatic areas. An optimum dose of 5000-6000 rad/five-six week is advisable for this kind of tumour. It is suggested that total body or hemibody irradiation be advisable for cases with distant metastases. Late sequela of cataract calls for meticulous protection of the eye during the initial radiotherapy.

摘要

1958年3月至1977年12月,我院对48例鼻腔非霍奇金淋巴瘤患者进行了放射治疗。在此期间,该疾病的发病率仅占所有恶性淋巴瘤的4.8%(48/983)。该肿瘤与起源于鼻咽、扁桃体和舌根的淋巴瘤的比例分别为1:2、1:3、9:1。其发生于左侧或右侧的几率相等,但有4例为双侧发病。有4例侵犯鼻咽,3例侵犯上颌窦,14例侵犯邻近软组织。经放射治疗的IA期和IIA期病变的1年、3年、5年、10年和15年生存率分别为96%、82%、78%、67%和44%。IIIA期病变的5年生存率为25%。所有经化疗和放疗联合治疗的IIIB期和IV期病变患者均在1年内死亡。侵犯邻近软组织和器官的患者5年生存率仅为25%和33%。预后受分期和放疗技术的影响。放疗野必须足够广泛,以包括整个鼻腔(越过中线1cm)、鼻咽、同侧上颌窦、硬腭及区域淋巴结区。对于这类肿瘤,最佳剂量为5000 - 6000拉德/五至六周。对于有远处转移的病例,建议进行全身或半身照射。白内障的晚期后遗症要求在初始放疗期间精心保护眼睛。

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