Sarris A H, Papadimitrakopoulou V, Dimopoulos M A, Smith T, Pugh W, Ha C S, McLaughlin P, Callender D, Cox J, Cabanillas F
University of Texas M.D. Anderson Cancer Center Department of Hematology, Houston 77030, USA.
Leuk Lymphoma. 1997 Jun;26(1-2):49-56. doi: 10.3109/10428199709109157.
Since the reported survival and failure-free survival (FFS) of adults with primary parotid non-Hodgkin's lymphoma (NHL) is variable, we reviewed our experience of untreated adults with primary parotid NHL. Patients were eligible if they presented to the University of Texas M. D. Anderson Cancer Center Cancer between 1980 and 1995 with parotid enlargement and if the diagnosis of lymphoma was verified according the Working Formulation. Medical records were reviewed to determine Ann Arbor Stage (AAS), the International Prognostic Index (IPI) score, response to therapy, relapse, FFS, and survival. We identified 39 untreated adults with primary parotid NHL representing 1% of all lymphomas and 8.6% of all untreated parotid neoplasms. Three patients were excluded because of suboptimal therapy, leaving 36 patients eligible for outcome analysis. Of the 18 patients with low-grade NHL, two were treated with radiotherapy, eight with chemotherapy and radiotherapy, seven with chemotherapy only, and one with antibiotics. The complete remission (CR) rate was 94%, and with a median follow-up of 36 months for surviving patients the survival and failure-free survival (FFS) at 5 years were 94% and 78%, respectively. The 5-year FFS were not statistically different between patients with early (I or II) or advanced (III or IV) AAS (83% and 74%, respectively; p > 0.05) and favorable (0 or 1) or unfavorable (> 1) IPI scores (73% and 100%, respectively; p > 0.05). All 18 patients with intermediate-grade NHL were treated with doxorubicin-based chemotherapy which was followed by radiotherapy in six. The CR rate was 89%, and with a median follow-up of 51 months for surviving patients the survival and FFS at 10 years were 80% and 72%, respectively. In this group 10-year FFS was better in early than in advanced AAS (100% vs 0%, respectively; p = 0.01) and in favorable (0 or 1) than in unfavorable (> 1) IPI scores (86% vs 20%, respectively; p < 0.01). We conclude the the FFS of patients with low-grade NHL is 78% and not affected by AAS or IPI score. The FFS of patients with intermediate-grade NHL appears comparable with that of NHLs of other primary sites, being 86% for those with IPI < or = 1 and 20% for those with IPI 1. Patients with IPI > 1 should be entered on investigational protocols aiming to increase FFS.
由于原发性腮腺非霍奇金淋巴瘤（NHL）成年患者报告的生存率和无失败生存率（FFS）存在差异，我们回顾了未经治疗的原发性腮腺NHL成年患者的治疗经验。1980年至1995年间，就诊于德克萨斯大学MD安德森癌症中心且有腮腺肿大、经工作分类法确诊为淋巴瘤的患者符合研究条件。查阅病历以确定Ann Arbor分期（AAS）、国际预后指数（IPI）评分、治疗反应、复发情况、FFS和生存率。我们确定了39例未经治疗的原发性腮腺NHL成年患者，占所有淋巴瘤患者的1%，所有未经治疗的腮腺肿瘤患者的8.6%。3例患者因治疗不充分被排除，剩余36例患者符合结果分析条件。18例低级别NHL患者中，2例接受放疗，8例接受化疗和放疗，7例仅接受化疗，1例接受抗生素治疗。完全缓解（CR）率为94%，存活患者的中位随访时间为36个月，5年生存率和无失败生存率（FFS）分别为94%和78%。早期（I或II期）或晚期（III或IV期）AAS患者（分别为83%和74%；p>0.05）以及IPI评分良好（0或1分）或不良（>1分）患者（分别为73%和100%；p>0.05）的5年FFS无统计学差异。所有18例中级NHL患者均接受了以阿霉素为基础的化疗，其中6例随后接受了放疗。CR率为89%，存活患者的中位随访时间为51个月，10年生存率和FFS分别为80%和72%。在该组中，早期AAS患者的10年FFS优于晚期患者（分别为100%和0%；p=0.01），IPI评分良好（0或1分）患者的10年FFS优于不良（>1分）患者（分别为86%和20%；p<0.01）。我们得出结论，低级别NHL患者的FFS为78%，不受AAS或IPI评分影响。中级NHL患者的FFS似乎与其他原发部位NHL患者相当，IPI≤1分患者的FFS为86%，IPI>1分患者的FFS为20%。IPI>1分的患者应纳入旨在提高FFS的研究方案。
