Touboul E, Merle Beral H, Grob R, Judet T, Fauchon F, Roy-Camille R, Guérin R A
Sem Hop. 1983 Nov 3;59(40):2751-7.
We report eleven cases of non-Hodgkin lymphoma (NHL) revealed by epidural involvement treated at the Pitié Salpêtrière Tumor Center over ten years. This condition is uncommon. The tumor can be excised after laminectomy, thus establishing diagnosis. Rather than on histological type, prognosis is dependent on the presence or absence of associated vertebral involvement. Four patients presented with apparently primary, localized, epidural involvement without vertebral lesions; they are still alive 2, 3, 6 and 11 years after onset. Prognosis is guarded in the seven other patients as they have vertebral involvement; other localizations are frequently found and survival does not exceed 8 to 36 months. Only 3 patients are still alive, 8 months, 10 months and 3 years after onset. We advocate preoperative irradiation of the tumor delivering 45.00 Grays, followed by systematic combination chemotherapy. Chemotherapy can be given both before and after radiotherapy in patients with vertebral bone involvement.
我们报告了在皮提耶尔-萨尔佩特里埃肿瘤中心接受治疗的11例因硬膜外受累而确诊的非霍奇金淋巴瘤(NHL)病例,这些病例是在十年间积累的。这种情况并不常见。肿瘤可在椎板切除术后切除,从而确立诊断。预后并非取决于组织学类型,而是取决于是否存在相关的椎体受累情况。4例患者表现为明显的原发性、局限性硬膜外受累,无椎体病变;发病后2年、3年、6年和11年仍存活。其他7例患者因有椎体受累,预后不佳;常发现有其他部位转移,生存期不超过8至36个月。只有3例患者仍存活,发病后8个月、10个月和3年。我们主张对肿瘤进行术前45.00格雷的放射治疗,随后进行系统性联合化疗。对于有椎体骨受累的患者,化疗可在放疗前后进行。