33例小肠非霍奇金淋巴瘤治疗分析

目的探讨小肠非霍奇金淋巴瘤的临床特点、诊断、治疗和预后。方法回顾性分析33例小肠非霍奇金淋巴瘤，其中滤泡型裂细胞性2例，弥漫型裂细胞性7例，弥漫型裂-无裂细胞性5例，弥漫型无裂细胞性6例，免疫母细胞性1例，黏膜相关淋巴组织淋巴瘤2例，弥漫性大B细胞淋巴瘤9例，另有1例为T细胞淋巴瘤。Ann Anbor分期ⅠE期12例，ⅡE期15例，ⅣE期6例。手术治疗33例，29例行根治术，另4例行姑息性切除术。26例行术后放疗，移动条照射12例，全腹盆腔大野照射14例；中位总剂量2543．5cGy。术后化疗33例，其中CHOP方案17例，COMP方案6例，COP方案3例，MINE方案2例，COPP方案3例，BACOP方案2例。结果5年总生存率和无病生存率分别为48％和39％，中位值分别为47、23个月。各期的生存率分别为ⅠE期42％，ⅡE期67％，ⅣE期17％。结论小肠淋巴瘤多为ⅠE、ⅡE期，病理以中、高度恶性为主，治疗多采用以手术为主的综合治疗，术后放疗及化疗可提高生存率。     

威克治疗老年中高度恶性非霍奇金淋巴瘤疗效观察

目的：研究小剂量长疗程口服国产三好威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤的临床疗效及不良反应。方法：采用小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤14例,其中弥漫性大细胞型4例,弥漫性小裂细胞型3例,弥漫性大小细胞混合型2例,免疫母细胞型3例,淋巴母细胞型1例,小无裂细胞裂1例。恶性程度为中、高度。分期为Ⅱ期－Ⅳ期。结果：CR3例,占21．4％;PR8例,占57．1％,有效率为78．6％。主要毒副作用为骨髓抑制和胃肠道反应,对肝功能影响轻微。结论：小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤按期近期疗效满意,毒副作用小,可在门诊治疗,费用低廉,值得临床推广。     

10例原发性宫颈淋巴瘤临床分析

目的探讨宫颈淋巴瘤的发病、诊断、治疗及预后。方法临床资料回顾性分析。结果本组病例占同期宫颈恶性肿瘤的０．９％,１０例患者平均年龄４３．６岁,７例有癌肿家族史,临床症状以阴道出血和／或白带增多为主,肿瘤形态为息肉型（４例）、糜烂型（４例）和结节型（２例）。按ＦＩＧＯ分期：Ⅰｂ期８例,Ⅱｂ期１例,Ⅳ期１例。本组病例均经病理确诊,病理类型上属非霍奇金淋巴瘤（ＮＨＬ）,Ｂ细胞性,其中弥漫型裂细胞性３例,裂－无裂细胞性４例。１０例患者采用手术和化疗为主的综合治疗,随访期３～６６个月,除１例术后４１个月腋下转移外,９例无瘤生存。结论如果发现早,治疗适当,宫颈淋巴瘤疗效并非很差。     

8例卵巢非霍奇金淋巴瘤临床分析

[目的]探讨卵巢非霍奇金淋巴瘤 (NHL)的临床表现、诊断、治疗及预后。 [方法]8例临床资料的回顾性分析。 [结果]本组病例占同期卵巢恶性肿瘤 0.51％ (8/1552)，继发 5例，原发 3例。按 FIGO分期Ⅰ期 1例，Ⅱ期 1例，Ⅲ期 3例，Ⅳ期 2例， 1例未行手术分期不明。病理类型均属非霍奇金淋巴瘤， B细胞性，裂 无裂细胞、混合细胞、小细胞各 2例，大无裂及中心细胞各 1例。本组单纯化疗 1例，余 7例均采用综合治疗。随访结果 5例死亡，生存期 1～ 21个月， 3例存活。 [结论]对于青壮年卵巢肿瘤患者，如肿瘤呈实性、双侧性且伴有 CA125增高者，应警惕卵巢淋巴瘤的可能；治疗多采用手术和化疗为主的综合治疗；原发较继发预后好，但原发甚罕见。     

眼眶原发恶性淋巴瘤的临床分析

目的　分析眼眶原发恶性淋巴瘤的治疗方法。方法　１５ 例眼眶原发恶性淋巴瘤均为非霍奇金淋巴瘤。 Ａｎｎ Ａｒｂｏｒ 分期：Ⅰ Ａ 期１１ 例,Ⅱ Ａ 期４ 例。放射治疗剂量３０ ～５８ Ｇｙ ,３ ～６ 周。结果　１ ,３ ,５ 年局部控制率分别为９４ ．１ ％ ,９２ ．３ ％ 和９２ ．３ ％ 。３ ,５ ,１０ 年生存率分别为１００ ％ ,９０ ％ 和７５ ％ 。有５ 例疾病进展。结论　放射治疗为主要治疗手段。推荐放射治疗剂量为３５ ～４５ Ｇｙ ,３ ．５ ～４ ．５ 周。不需行淋巴引流区预防照射。对恶性程度高及有眶外侵犯者应加化疗。     

ProMACE／CytaBOM方案治疗中高度非霍奇金淋巴瘤

目的：研究ＰｒｏＭＡＣＥ／ＣｙｔａＢＯＭ方案治疗中、高长恶性非霍奇金淋巴瘤的临床疗效及不良反应。方法：采用ＰｒｏＭＡＣＥ／ＣｙｔａＢＩＯＭ方案治疗非奇金 。其中弥漫性大细胞型２１例，弥漫性小裂细胞型３例弥漫性大小细胞混合型４例，免疫母细胞型３例，淋巴母细胞型２例，小无裂细胞型１例。恶性程度为中高度。分期为Ⅱ～Ⅳ期，结果：ＣＲ２３例，占６７．６％；ＰＲ６例，占１７．６％。有效率为８５．３％。主要毒副     

ProMACE/CytaBOM方案治疗中高度非霍奇金淋巴瘤

目的 :研究ProMACE/CytaBOM方案治疗中、高度恶性非霍奇金淋巴瘤的临床疗效及不良反应。方法 :采用ProMACE/CytaBOM方案治疗非霍奇金淋巴瘤 34例。其中弥漫性大细胞型 2 1例 ,弥漫性小裂细胞型 3例 ,弥漫性大小细胞混合型 4例 ,免疫母细胞型 3例 ,淋巴母细胞型 2例 ,小无裂细胞型1例。恶性程度为中高度。分期为Ⅱ～Ⅳ期。结果 :CR 2 3例 ,占 67.6% ;PR 6例 ,占 17.6% ;有效率为85.3%。主要毒副作用为骨髓抑制和胃肠道反应。结论 :ProMACE/CyatBOM方案治疗中高度恶性非霍奇金淋巴瘤近期疗效确切 ,毒副作用可耐受 ,值得临床推广。     

威克治疗老年中高度恶性非霍奇金淋巴瘤疗效观察

目的:研究小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤的临床疗效及不良反应.方法:采用小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤14例.其中弥漫性大细胞型4例,弥漫性小裂细胞型3例,弥漫性大小细胞混合型2例,免疫母细胞型3例,淋巴母细胞型1例,小无裂细胞型1例.恶性程度为中、高度.分期为Ⅱ期～Ⅳ期.结果:CR3例,占21.4%;PR8例,占57.1%;有效率为78.6%.主要毒副作用为骨髓抑制和胃肠道反应,对肝功能影响轻微.结论:小剂量长疗程口服国产威克软胶囊治疗老年中、高度恶性非霍奇金淋巴瘤近期疗效满意,毒副作用小,可在门诊治疗,费用低廉,值得临床推广.     

8例卵巢非霍奇金淋巴临床分析

[目的]探讨卵巢非霍奇金淋巴瘤（NHL）的临床表现、诊断、治疗及预后。[方法]8例临床资料的回顾性分析。[结果]本组病例占同期卵巢恶性肿瘤0.51%(8/1552)，继发5例，原发3例，按FIGO分期Ⅰ期1例，Ⅱ期1例，Ⅲ期3例，Ⅳ期2例，1例未行手术分期不明，病理类型均属非霍奇金淋巴瘤，B细胞性，裂-无裂细胞、混合细胞、小细胞各2例，大无裂及中心细胞各1例，本组单纯化疗1例，余7例均采用综合治疗，随访结果5例死亡，生存期1-21个月，3例存活，[结论]对于青壮年卵巢肿瘤患者，如肿瘤呈实性、双侧性且伴有CA125增高者，应警惕卵巢淋巴瘤的可能；治疗多采用手术和化疗为主的综合治疗；原发较继发预后好，但原发甚罕见。     

Ⅰ和Ⅱ期结内型非霍奇金淋巴瘤治疗方法探讨（附132例临？…

目的 探讨Ⅰ，Ⅱ期结内型非堆奇金淋巴瘤（ＮＨＬ）有效方法。方法 １３２例Ⅰ，Ⅱ期结内型非霍奇金淋巴瘤分别采用单纯放射治疗、放射治疗＋化疗、化疗＋放射治疗＋化疗、化疗＋放射治疗和单纯化疗治疗。结果 Ⅰ期结内型高度恶性ＮＨＬ单纯放射治疗３，５，７年自下而上率及７年复发率与综合治疗组间差异均无显著意义（Ｐ〉０．０５）。Ⅰ期结内型中、低度恶性ＮＨＬ３，５，７年生存率单纯放射治疗组分别为９５．０％，９０．０     

Lymphomes malins non hodgkiniens

With approximately 10000 cases per year in France, non-Hodgkin's lymphoma (NHL) represents the most frequent hematological malignancy, and 5 to 10 % of new cases of cancers. NHLs constitute a heterogeneous group of lymphoproliferative diseases, including entities with very different epidemiological and evolutive characteristics, as well as prognosis and treatments. Several classifications exist, but in practice, we individualize aggressive NHL including Diffuse Large B-Cell Lymphomas (DLBCL) which is the most common lymphoma, and indolent NHL including follicular lymphomas and mucosa-associated lymphoid tissue (MALT) lymphomas. The role of the radiotherapy in the management of NHLs varies according to the specific sub-type of lymphoma, but it has become increasingly limited over time. Overall it finds indications with curative intent only in situations of localized LMNH: either associated with chemotherapy as part of a combined modality therapy as for the treatment of localized DLBCL, or as exclusive treatment specially in the rare situations of localized follicular lymphomas. Moreover, lymphocytes being extremely radiosensitive cells, radiotherapy retains excellent indications with palliative intent for the management of symptomatic bulky tumor masses, and that whatever the sub-type of NHLs may be. It is important to remember that even today the «Involved Field» irradiation type remains the gold standard for the treatment of nodal NHLs, even if we witness at present the emergence of new types of irradiation, which aim to reduce the amount of irradiated tissues to try to limit the risks of delayed radio-induced complications. The purpose of this article is to clarify the specific aspects (epidemiological, radio-anatomical and prognostic characteristics) of each NHLs'sub-types (except primary central nervous system lymphomas), as well as the practical modalities of the irradiation (illustrated by a clinical case record) when an indication of radiotherapy is placed for their treatment.     

Radio-chemotherapy combinations in non operable localized non small cell lung carcinoma: updates and perspectives

Optimal treatment of non operable localized non small cell lung carcinoma (NSCLC) continues to evolve. Increasing overall survival must evolute through improving local tumoral control and eradication of probable occult metastasis. Historically, median survival varies between 7 and 10 months with a standard conventional fractionated radiotherapy (RT). Induction chemotherapy (CT) followed by RT has demonstrated its superiority over RT alone, modality which is widely utilised. Other studies revealed best results with decreasing metastatic relapses. Three independent meta-analysis confirmed benefit obtained with cisplatin based CT followed by RT that allowed to consider this association as a gold standard. Other authors demonstrated an improvement of local control and survival with concomitant RT-CT or hyperfractionated accelerated RT. Results of all of these new therapeutic modalities still poor. Implication of new CT drugs has conducted for an emergence of new studies finding to demonstrate more encouraging results. Randomized trials are conducted in this way.     

Cancer bronchique non à petites cellules

The objective was the drafting of a document describing the technique of tridimensional conformal irradiation of a non small cell lung cancer (NSCLC). Principles and recommendations concern patients affected by lung cancer localized in the thorax and inoperable or patients who must undergo postoperative irradiation. They have been developed according to the current scientific data from an analysis of the literature and professional agreements. Principles and recommendations describe : the centering and the contouring of tumor volumes and organs at risk, the calculation of the dose distribution, the treatment and the surveillance during the treatment.     

Dystrophic calcification in non specific thyroiditis

A case of intense calcification in thyroiditis involving only the isthmus of thyroid gland is discussed.     

Pathology of extra-nodal non Hodgkin lymphomas

In the management of extra-nodal lymphomas it is important to determine whether the tumour has disseminated and whether lymph nodes are involved. Some extra-nodal lymphomas may be the result of random spread of nodal lymphoma. Specific homing, however, determines the site of many extra-nodal lymphomas, as exemplified by cutaneous T-cell lymphomas, which seem to be derived from skin-homing T-cells and mucosa-associated lymphoid tissue lymphomas that show features of the mucosal immune system. Enteropathy-associated T-cell lymphoma is derived from mucosal T-cells in patients with coeliac disease. Immunological sanctuary accounts for the localisation of primary brain, eye and testicular lymphoma. Mantle cell lymphoma frequently causes tumours in the gastrointestinal tract. Random biopsies have shown that a high proportion of patients with this lymphoma have extensive occult involvement of the gastrointestinal tract at the time of first diagnosis. Follicular lymphoma occurs at both nodal and extra-nodal sites, but uncommonly at both sites at the same time. Extra-nodal follicular lymphomas frequently lack t(14;18)(q32;q21) and do not express bcl-2, which are characteristics of the nodal disease. At extra-nodal sites, follicular lymphoma is more likely to be curable than nodal follicular lymphoma. The behaviour of extra-nodal lymphomas cannot be assumed to follow that of their nodal counterparts.