Pendlebury S, el Awadi M, Ashley S, Brada M, Horwich A
St George Hospital, Sydney, New South Wales, Australia.
Radiother Oncol. 1995 Sep;36(3):167-71. doi: 10.1016/0167-8140(95)01600-l.
This is a retrospective review of stages I and II low grade nodal non-Hodgkin's lymphoma (NHL) seen at the Royal Marsden Hospital and treated with radiotherapy alone. From January 1970 to December 1989, 58 patients were treated. The Ann Arbor staging system was modified to subdivide stage II into localised and extensive disease, with localised disease representing no more than two contiguous regions. There were 40 stage I patients and 18 stage II patients (eight localised and 10 extensive). Volume of the radiotherapy was involved field only in 30 patients and extended fields in 28 patients. The median dose was 40 Gy in 20 fractions. The pattern of relapse was assessed as being systemic or within the standard volume. Survival and progression-free survival (PFS) were calculated. Prognostic variables of age, histology, stage and radiotherapy volume were analysed by multivariate analysis. The 5- and 10-year PFS for the total group were 59 and 43%, and corresponding OS figures were 93 and 79%. Age less than 60 years was a predictor of improved survival but not for PFS and we found no significance in histology, stage or extent of radiotherapy field for the other variables. All relapses occurred with disease outside the original volume, with three patients also relapsing in-field. Treatment of this disease produced an OS at 10 years of 79%. The plateau on the PFS plot suggested that some patients are cured. Young age was the only prognostic factor found for survival. Relapse is most frequently outside the treated volume. Our current treatment policy for stage I and II low grade NHL is involved field radiotherapy to a dose of 35 Gy in 20 fraction over 4 weeks.
这是一项对在皇家马斯登医院就诊且仅接受放射治疗的Ⅰ期和Ⅱ期低度淋巴结非霍奇金淋巴瘤（NHL）的回顾性研究。1970年1月至1989年12月期间，共治疗了58例患者。Ann Arbor分期系统进行了修改，将Ⅱ期细分为局限性和广泛性疾病，局限性疾病定义为不超过两个相邻区域。其中Ⅰ期患者40例，Ⅱ期患者18例（8例局限性和10例广泛性）。30例患者放疗范围仅为受累野，28例患者为扩大野。中位剂量为40 Gy，分20次给予。复发模式评估为全身性或在标准体积内。计算生存率和无进展生存期（PFS）。通过多因素分析对年龄、组织学、分期和放疗体积等预后变量进行分析。全组的5年和10年PFS分别为59%和43%，相应的总生存期（OS）数据分别为93%和79%。年龄小于60岁是生存率提高的预测因素，但对PFS无影响，我们发现组织学、分期或放疗野范围对其他变量无显著意义。所有复发均发生在原体积外的疾病部位，3例患者也有野内复发。该疾病的治疗10年OS率为79%。PFS曲线的平台期表明部分患者已治愈。年轻是唯一发现的生存预后因素。复发最常见于治疗体积外。我们目前对Ⅰ期和Ⅱ期低度NHL的治疗策略是受累野放疗，剂量为35 Gy，分20次，在4周内给予。
