原发骨非霍奇金淋巴瘤临床分析

目的:探讨原发骨非霍奇金淋巴瘤的临床特点、诊断、治疗及预后。方法:选择1970年11月～2003年2月我院收治的21例原发于骨的非霍奇金淋巴瘤,其中Ⅰ期14例(66.7%),Ⅱ期2例(9.5%),Ⅳ期5例(23.8%)。弥漫性大B细胞型12例(57.1%),混合细胞型4例(19.0%),小淋巴细胞型1例(4.8%),T细胞型1例(4.8%),未分型3例(14.3%)。采用单纯放疗6例(28.6%),放疗和化疗综合治疗15例(71.4%)。结果:中位随访86个月,2例(9.5%)局部复发,9例(42.9%)出现远处受侵,3年、5年、10年无进展生存率分别为56.7%、38.9%、29.1%;3年、5年、10年总生存率分别为69.1%、42.2%、42.2%。结论:原发于骨的非霍奇金淋巴瘤首选放疗和化疗的综合治疗;放疗剂量推荐45Gy～46Gy。

Clinical Analysis of Primary Non-Hodgkin's Lymphoma of Bone

Objective: To analyze the clinical characteristics, diagnosis, treatment and prognosis of primary Non-Hodgkin's lymphoma of bone (PLB). Methods: Twenty-one patients diagnosed with PBL in Cancer Hospital Chinese Academy of Medical Sciences between Nov. 1970 and Feb. 2003 were reviewed. Fourteen patients presented with stage I (66.7%), 2 with stage II (9.5%),and 5 with stage IV (23.8%). Twelve patients (57.1%) had a diffuse large B cell lymphoma, four (19.0%) had a mixed cell lymphoma, one (4.8%) had a small lymphocyte lymphoma, one (4.8%) had T cell lymphoma, and three (14.3%) had unclassified Non-Hodgkin's lymphoma. Six patients (28.6%) received radiotherapy alone and fifteen patients (71.4%) received radiotherapy combined chemotherapy. Results: The median follow-up for the whole group was 86 months, two patients (9.5%) had local relapse and nine (42.9%) experienced distant involvement. The disease free survival rates for 3-year, 5-year and 10-year were 56.7%、38.9%、29.1%, respectively. The overall survival rates for 3-year, 5-year and 10-year were 69.1%、42.2%、42.2%, respectively. Conclusions: Combination therapy including radiotherapy and chemotherapy is the optimal treatment for PLB. The recommended dose of radiotherapy is 4500cGy~ 4600cGy.