Avilés A, Delgado S, Ruiz H, de la Torre A, Guzman R, Talavera A
Department of Hematology, Oncology Hospital, National Medical Center, México.
Eur J Cancer B Oral Oncol. 1996 Jan;32B(1):19-23. doi: 10.1016/0964-1955(95)00058-5.
Treatment of stage IA non-Hodgkin's lymphoma (NHL) of Waldeyer's ring remains controversial, probably because of the small number of patients and the scarcity of controlled studies. Between 1981 and 1991, 316 patients with stage I NHL of Waldeyer's ring were randomised for treatment with radiotherapy alone (extended fields), 101 patients; combined chemotherapy with a regimen of CHOP (cyclophosphamide, vincristine, doxorubicin, and prednisone) or CHOP-like (epirubicin instead of doxorubicin), 106 patients; and combined therapy (radiotherapy followed by the same combination chemotherapy), 109 patients. Median follow-up was 6.8 years. Complete response was achieved in 93, 87 and 97%, respectively. Relapses were least frequent in patients treated with combination therapy. The 5-year rate for failure-free survival was 48% for radiation therapy, 45% for the patients who were treated with chemotherapy, which was statistically significantly less than the 83% for patients treated with combined therapy (P < 0.001). Overall survival was also better in the combined therapy arm: 90%, statistically different to 58% for the patients treated with chemotherapy alone and 56% for patients treated with radiation therapy (P < 0.001). Toxicity was mild and late side-effects were not observed in any patients. From these results combined therapy should be considered as the best therapeutic approach in patients with localised NHL of Waldeyer's ring.
对于瓦尔代尔环IA期非霍奇金淋巴瘤（NHL）的治疗仍存在争议，可能是因为患者数量较少且缺乏对照研究。1981年至1991年间，316例瓦尔代尔环I期NHL患者被随机分为三组接受治疗：单纯放疗（扩大野），101例患者；采用CHOP方案（环磷酰胺、长春新碱、多柔比星和泼尼松）或类似CHOP方案（表柔比星代替多柔比星）进行联合化疗，106例患者；联合治疗（放疗后采用相同的联合化疗方案），109例患者。中位随访时间为6.8年。完全缓解率分别为93%、87%和97%。联合治疗的患者复发最少。单纯放疗的5年无失败生存率为48%，接受化疗的患者为45%，这在统计学上显著低于联合治疗患者的83%（P<0.001）。联合治疗组的总生存率也更高：为90%，与单纯化疗患者的58%和单纯放疗患者的56%在统计学上有差异（P<0.001）。毒性较轻，且未观察到任何患者出现晚期副作用。基于这些结果，联合治疗应被视为瓦尔代尔环局限性NHL患者的最佳治疗方法。
