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1.
原发于涎腺的非霍奇金淋巴瘤临床分析   总被引:1,自引:0,他引:1  
目的探讨原发于涎腺非霍奇金淋巴瘤(NHL)的临床、病理特点,治疗方法和预后。方法18例原发于涎腺的非霍奇金淋巴瘤经术后病理证实。术后放射治疗15例,单纯放疗10例,放疗加化疗5例,单纯化疗2例,未治疗1例。放射治疗剂量为40-55Gy(1.8—2.0Gy/次,5次/周),化疗采用CHOP方案1—4周期。结果5年生存率76.0%,10年生存率60.2%,2例患者死于远处转移。结论涎腺NHL以低度恶性淋巴瘤多见,术后放射治疗为主的局部治疗有较好效果。早、中期患者宜采用放射治疗,晚期患者以放疗加化疗为宜。  相似文献   

2.
目的:探讨Ⅰ、Ⅱ期鼻咽非霍奇金淋巴瘤(NHL)的治疗方法.方法:1995年1月~2001年1月我院收治Ⅰ、Ⅱ期鼻咽非霍奇金淋巴瘤90例,采用单纯放射治疗及放射治疗加化疗.结果:Ⅰ期患者单纯放疗组3、5年生存率分别为94.4%、88.9%,放疗加化疗组3、5年生存率分别为92.3%、84.6%.Ⅱ期中度恶性的患者单纯放疗组3、5年生存率分别为62.5%、50%,放疗加化疗组3、5年生存率分别为92.9%、85.7%.结论:Ⅰ期鼻咽非霍奇淋巴瘤可采用单纯放射治疗.Ⅱ期中度恶性鼻咽非霍奇淋巴瘤采用综合治疗.  相似文献   

3.
目的:探讨Ⅰ、Ⅱ期鼻咽非霍奇金淋巴瘤(NHL)的治疗方法。方法:1995年1月~2001年1月我院收治Ⅰ、Ⅱ期鼻咽非霍奇金淋巴瘤90例,采用单纯放射治疗及放射治疗加化疗。结果:Ⅰ期患者单纯放疗组3、5年生存率分别为94.4%、88.9%,放疗加化疗组3、5年生存率分别为92.3%、84.6%。Ⅱ期中度恶性的患者单纯放疗组3、5年生存率分别为62.5%、50%,放疗加化疗组3、5年生存率分别为92.9%、85.7%。结论:Ⅰ期鼻咽非霍奇淋巴瘤可采用单纯放射治疗。Ⅱ期中度恶性鼻咽非霍奇淋巴瘤采用综合治疗。  相似文献   

4.
目的:分析影响Ⅰ期和Ⅱ期原发于头颈部非霍奇金淋巴瘤预后因素,寻求合理的治疗方案.方法:1994年6月至2000年6月共收治Ⅰ期和Ⅱ期原发于头颈部非霍奇金淋巴瘤54例,分别采用单纯放疗,放疗+化疗和单纯化疗.放疗多采用局部野或局部扩大野照射,原发部位DT50Gy~55Gy,邻近一站淋巴结区预防剂量DT45Gy.化疗用CHOP方案,化疗4~6周期.结果:全组5年生存率为64%,其中Ⅰ期为75%,Ⅱ期为47%(P<0.05).低度恶性、中度恶性、高度恶性患者5年生存率分别为70%、54%、39%,其中低度恶性组5年生存率明显高于高度恶性组(P<0.05).放疗+化疗组5年生存率69%,明显高于其它二组(P<0.05).单纯放疗及放疗+化疗治疗后局部控制率达92%,明显高于单纯化疗组(P<0.05).单纯化疗组治疗后局部复发率较高,达37.5%.结论:临床分期、病理类型及治疗方法是影响其预后的主要因素.单纯化疗组治疗后局部复发率较高,提示放疗在早期非霍奇金淋巴瘤治疗中还是占有比较重要的地位,不能用单纯化疗取代放疗,有计划的放疗+化疗是提高局部控制率和生存率的关键.  相似文献   

5.
目的评价原发鼻腔非霍奇金淋巴瘤(NHL)放疗和化疗的近期疗效,并对影响预后的因素进行分析。方法1993年1月至2002年12月收治的原发鼻腔NHL70例全部经病理证实,其中T细胞来源52例,B细胞来源2例,NK/T细胞来源16例。放疗主野为鼻前凸字形野,辅单或双侧耳前野,累及口咽者先用面颈联合野,放疗采用60^Co或直线加速器常规放射,2Gy/次。鼻腔靶区中位剂量54Gy(36~66Gy)。辅助化疗在放疗前、中、后进行或单纯化疗,方案为COP、CHOP、COBDP。用COX模型对影响预后的多因素进行分析。结果单化组、单放组、放加化组局部控制率分别为12.5%、66.7%、74.0%,5年总生存率分别为12.5%、50.0%、62.0%(P〈0.05)。首程治疗后的CR率是独立的预后因素,除Ann Arbor分期外,局部侵犯范围、发热、治疗方法也是影响预后的主要因素,而病理类型、性别、年龄及全身症状等因素对预后影响不大。结论放化疗联合治疗原发鼻腔NHL的生存率优于单纯放疗和单纯化疗。对于原发鼻腔NHL的治疗有条件者可试用自体干细胞移植。  相似文献   

6.
目的:分析影响Ⅰ期和Ⅱ期原发于头颈部非霍奇金淋巴瘤预后因素,寻求合理的治疗方案。方法:1994年6月至2000年6月共收治Ⅰ期和Ⅱ期原发于头颈部非霍奇金淋巴瘤54例,分别采用单纯放疗,放疗 化疗和单纯化疗。放疗多采用局部野或局部扩大野照射,原发部位DT50Gy~55Gy,邻近一站淋巴结区预防剂量DT45Gy。化疗用CHOP方案,化疗4~6周期。结果:全组5年生存率为64%,其中Ⅰ期为75%,Ⅱ期为47%(P<0.05)。低度恶性、中度恶性、高度恶性患者5年生存率分别为70%、54%、39%,其中低度恶性组5年生存率明显高于高度恶性组(P<0.05)。放疗 化疗组5年生存率69%,明显高于其它二组(P<0.05)。单纯放疗及放疗 化疗治疗后局部控制率达92%,明显高于单纯化疗组(P<0.05)。单纯化疗组治疗后局部复发率较高,达37.5%。结论:临床分期、病理类型及治疗方法是影响其预后的主要因素。单纯化疗组治疗后局部复发率较高,提示放疗在早期非霍奇金淋巴瘤治疗中还是占有比较重要的地位,不能用单纯化疗取代放疗,有计划的放疗 化疗是提高局部控制率和生存率的关键。  相似文献   

7.
135例鼻腔非霍杰金淋巴瘤的治疗与预后分析   总被引:3,自引:0,他引:3  
目的 评价化疗、放疗、放疗+化疗及自体外周血干细胞移植(APBSCT)联合全身放疗(TBI)四种治疗方法对原发鼻腔非霍奇金淋巴瘤的疗效,并对影响预后的因素进行分析.方法 20年间收治的原发鼻腔非霍奇金淋巴瘤135例全部经病理证实,其中T细胞来源122例,B细胞来源12例,NK细胞来源1例.放疗主野为鼻前凸字野,辅单或双侧耳前野,累及口咽者先用面颈联合野.鼻腔靶区中位剂量56.0Gy(35.2~75.5Gy).TBI组剂量为8Gy,有2例原发灶加量30Gy.辅助化疗在放疗前、中、后进行或单纯化疗,方案为COP、COPP、COMP、CHOP、COBDP.用Cox模型对影响预后的多因素进行分析.结果 单化组、单放组、放加化组及APBSCT联合TBI组局部控制率分别为12%、69%、76%、83%(P=0.057),5年总生存率分别为9%、52%、63%、83%(P=0.032).除Ann-Arbor分期外,局部侵犯范围、治疗方法也是影响预后的主要因素,而病理类型、性别、年龄及全身症状等因素对预后影响不大.结论 放化联合的生存率优于单纯放疗.在Ann Arbor分期的基础上依照局部侵犯部位进一步分区,对评价预后有意义.对于原发鼻腔非霍奇金淋巴瘤的治疗有条件者可试用APBSCT联合TBI.  相似文献   

8.
目的:评价化疗、放疗、放疗+化疗3种治疗方法对原发咽淋巴环非霍奇金淋巴瘤的疗效,并对影响预后的因素进行分析。方法:9年间收治的原发咽淋巴环非霍奇金淋巴瘤157例全部经病理确诊,其中T细胞来源116例,B细胞来源35例,其他病理类型6例。放疗者靶区主要为咽淋巴环及全颈,肿瘤量DT40~65Gy(4~7周)。辅助化疗在放疗前、中、后进行或单纯化疗,化疗方案以CHOP方案为主,也有选用COP、C/DPP、COMP、COBDP等方案。用Cox模型对影响预后的多因素进行分析。结果:单放组、单化组、放化综合组局部控制率分别为62%、16%和80%,5年总生存率分别为30.43%、51.35%和59.79%,除Ann-Arbor分期外,治疗方法、全身症状也是影响预后的因素,而病理类型、性别、年龄等因素对预后影响不大。结论:放化联合的生存率优于单纯放疗。  相似文献   

9.
鼻腔非霍奇金淋巴瘤的治疗与预后分析   总被引:3,自引:0,他引:3  
目的:分析鼻腔非霍奇金淋巴瘤的预后因素。方法:自1991年11月至2001年4月该院治疗90例I,Ⅱ期鼻腔非霍奇金淋巴瘤,LDH异常10例,正常89例,有全身症状32例;12例行颈部预防照射。鼻腔靶区中位剂量54.4Gy(20.0Gy-69.5Gy)。全组1例手术后行放,化疗,1例行单纯化疗,6例单纯放疗,其余行放,化疗。放疗前,中,后行COP,COMP,CHOP,BACOP方案化疗2-8个疗程。结果:该组病例中位生存期为70个月,5个生存率为66.2%。单因素及多因素分析结果显示肿瘤局部侵犯范围,LDH异常,有全身症状及分期对生存率和远处侵犯率有显著影响(P<0.01)。结论:肿瘤局部分犯范围,LDH异常,有全身症状及分期是影响鼻腔非霍奇金淋巴瘤生产率及远处侵犯的主要因素。I期不必行颈部预防照射。  相似文献   

10.
 目的 评价化疗、放疗、放疗加化疗及自体外周血干细胞移植(APBSCT)联合全身照射(TBI)4种治疗方法对原发鼻腔的非霍奇金淋巴瘤(N-NHL)的疗效。方法 1980年至2000年间我院收治的原发鼻腔非霍奇金淋巴瘤(N-NHL)138例进行回顾分析。放射治疗:主野鼻前"凸"字野,辅单或双侧耳前野,累及口咽者先用面颈联合野。鼻腔靶区中位剂量56.0(35.2~75.5)Gy。化疗:放射治疗前、中、后或单纯化疗,方案为COP,COPP,COMP,CHOP,COBDP。6例为APBST联合 TBI 。TBI组剂量为6MV X 线8 Gy,有两例原发灶加量30 Gy。结果 单化组、单放组、放疗加化疗组及APBST联合 TBI组局部控制率分别为12 %,69 %,76 %,83 %;5年总生存率分别为9 %,52 %,63 %,83 %。APBSCT联合TBI组生存率优于放疗加化疗组,而放疗加化疗组优于单放组,单放组优于单化组(P<0.05)。结论 放化疗结合的治疗应成为N-NHL的主要治疗方法,而APBSCT联合TBI取得了更好的疗效。  相似文献   

11.
原发睾丸非霍奇金淋巴瘤26例临床分析   总被引:3,自引:0,他引:3  
目的:探讨原发睾丸非霍奇金淋巴瘤(non-Hodgidn’s lymphoma,NHL)的临床特点、治疗方法。方法:收集我院1980年10月至2002年2月收治的睾丸NHL26例,Ann Arbor分期ⅠE期17例,ⅡE期6例,ⅣE期3例。全部手术治疗。首程术后化疗24例,以CHOP方案为主,3~6周期,化疗加放疗9例,其中对盆腔/腹主动脉旁/阴囊等区域进行预防性放疗7例,针对病灶区放疗2例。阴囊区用9~12M eV电子线,其余用6~8MV-X线照射。照射剂量范围在36~50Gy,预防照射的平均剂量为40Gy。单纯手术和手术加放疗各1例。结果:全组一、三、五年总体生存率和无进展生存率分别为96.0%、78.1%、52.0%和70.2%、55.3%、49.2%。总失败率为53.8%,其中对侧睾丸、中枢神经系统受侵率分别为15.4%、11.5%,腹膜后淋巴转移率19.2%。结论:睾丸NHL一般为中-高度恶性,结外器官和淋巴结受侵率高,睾丸和腹膜后区分别占结外器官和淋巴结受侵的首位。所有期别的睾丸NHL都应化疗。ⅠE、ⅡE期病例应常规行腹主动脉旁、同侧髂血管旁和阴囊区预防性照射。ⅢE、ⅣE期以化疗为主,残留病灶辅以局部放疗。  相似文献   

12.
原发于上颌窦非霍奇金淋巴瘤15例临床分析   总被引:1,自引:0,他引:1  
目的对原发于上颌窦非霍奇金淋巴瘤的临床、病理、治疗及预后结合文献进行分析。方法经手术后病理确诊为原发于上颌窦非霍奇金淋巴瘤15例在本院行放疗和化疗的综合治疗。放疗采用60Co-γ线或6MV~8MV高能X线,原发灶放疗中位剂量为56Gy,颈部放疗剂量为50Gy,颈部预防放疗剂量为44Gy。放射治疗前后行CHOP、COPP、COMP、BACOP等方案化疗2个~6个周期。结果5年生存率为53.4%。死亡8例,均死于远处转移。结论上颌窦非霍奇金淋巴瘤需行放射治疗和全身化疗,有条件时给予鞘内预防化疗。  相似文献   

13.
原发鼻腔T/NK-T细胞非霍奇金淋巴瘤34例临床分析   总被引:1,自引:1,他引:0       下载免费PDF全文
 目的 探讨原发鼻腔T细胞性非霍奇金淋巴瘤(NHL)的临床特点及治疗。方法 回顾分析1997年1月至2001年12月收治的鼻腔T细胞性NHL34例。其中23例用化、放疗联合治疗,9例用单纯化疗,2例未治疗。所有化疗均采用标准CHOP方案。结果 单纯化疗组有效率为44.4 %,CR率为22.2 %;化、放联合治疗组有效率为100.0 %,CR率86.9 %。全组1年、3年、5年生存率分别为52.9 %,41.2 %,18.3 %。化、放联合治疗组5年生存率高于单纯化疗组;局限于鼻腔(ⅠE期)者,5年生存率高于有远处播散者(>ⅠE期)。结论 原发性鼻腔T细胞NHL 预后不良,用标准CHOP方案化疗疗效差,联合化、放疗有助于改善预后。  相似文献   

14.
目的 分析青少年儿童原发系统性间变大细胞淋巴瘤(ALCL)患者接受CHOP方案化疗 ±受累野放疗的疗效。方法 回顾分析本院1998—2010年收治的 28例青少年、儿童ALCL患者资料。Ⅰ、Ⅱ期 12例中单纯化疗 2例、综合治疗 10例,Ⅲ、Ⅳ期 16例中单纯化疗 14例、综合治疗 2例。CHOP方案 15例、CHOP联合其他高强度化疗 13例。化疗周期数 3~17个(中位数6个)。放疗多为受累野照射,剂量 39.6~50.0 Gy (中位数45 Gy)。结果 全组患者首程疗后达CR者 25例(89%),3例病变进展。中位随访时间45.3个月。全组 5年无事件生存率为80%,5年OS为93%。疗终达CR者 5年OS为100%,而未达CR者无 5年OS (P=0.000)。≥2个结外器官受侵者 5年无事件生存率为38%,而<2个结外器官受侵者的为85%(P=0.010)。结论 青少年、儿童原发系统性ALCL按成人方案治疗效果满意,但还需要长期随访。  相似文献   

15.
目的探讨原发性鼻腔NK/T细胞非霍奇金淋巴瘤的临床特点及治疗方法。方法回顾性分析7例鼻腔NK/T细胞淋巴瘤的临床资料,其中5例采用化、放疗联合治疗,1例采用单纯化疗,1例采用单纯放疗,化疗方案为CHOP方案或EPOCH方案。结果单一放疗或化疗效果差,采用EPOCH方案化疗联合局部侵犯野放疗的效果较好。结论对原发性鼻腔NK/T细胞淋巴瘤,采用CHOP方案化疗疗效差,采用EPOCH方案化疗联合放疗预后较好。  相似文献   

16.
Nasal NK/T cell is a rare form of usually localized non-Hodgkin's lymphoma (NHL) which generally carries a poor prognosis when treated with conventional NHL chemotherapy protocols. We reviewed 20 consecutive localized stage I/II nasal NK/T cell lymphomas treated at our institution over a 29 year period. Median age was 44 (range 23-71). Front-line therapy was generally radiotherapy alone (35-70 Gy) before 1980 and combination chemotherapy after 1980. Six patients were treated with first-line radiotherapy and they achieved complete remission (CR). Two subsequently received combination chemotherapy. Five of those patients remained in complete remission, after 97+ to 277+ months. Twelve patients were treated with first-line chemotherapy including CHOP or CHOP-like regimen in seven cases, and COP in five cases. Only three of them achieved CR, five had partial response and four had progressive disease. Five of the seven patients treated with CHOP did not achieve complete remission. The nine patients who failed to achieve CR with chemotherapy subsequently received salvage radiotherapy but only two of them obtained CR. Finally, two patients were treated with alternated chemotherapy and radiotherapy and achieved CR, which persisted after 14+ and 26+ months. Median survival was not reached in patients who received front-line radiotherapy, and was 35 months in patients who received front-line chemotherapy. These findings confirm that chemotherapy gives a low complete remission rate in localized nasal NK/T cell lymphoma. By contrast, first-line radiotherapy seems to give favorable results, whereas its results are poorer when administered after resistance to chemotherapy. Whether the use of chemotherapy after radiotherapy, or alternated chemotherapy-radiotherapy regimens give better clinical results than radiotherapy alone will have to be evaluated prospectively in this type of NHL.  相似文献   

17.
Guo Y  Lu JJ  Ma X  Wang B  Hong X  Li X  Li J 《Oral oncology》2008,44(1):23-30
The objective of this analysis was to evaluate the efficacy and treatment outcome of CHOP and CHOP combined with nitrosourea chemotherapy in natural killer (NK)/T-cell lymphoma of the nasal cavity. Sixty-three patients with NK/T-cell lymphoma of the nasal cavity were treated with CHOP or CHOP combined with oral nitrosourea chemotherapy between January 1997 and June 2005. By the Ann Arbor Lymphoma Staging Classification, 57 patients (90%) had Stage IE or IIE disease and six patients (10%) had Stage III or IV disease. All patients with Stage IE or IIE disease were intended to be treated curatively with combined chemoradiation; and patients who had Stage III or IV disease were treated with chemotherapy alone with curative intention. Chemotherapy consisted of: (1) up to six cycles of the standard CHOP based regimen, or (2) up to six cycles of the standard CHOP based regimen with oral Semustine dosed at 120 mg (or Lomustine dosed at 100mg) on day 1 of each chemotherapy cycle. External beam radiation therapy was delivered by daily conventional fractionation by Co-60 or 6MVx linear accelerator for patients with Stage IE or IIE disease. The radiation dose to the tumor bed was between 36 and 50 Gy with a median dose of 45 Gy. Fifty-three patients received chemotherapy prior to radiation, and four patients were treated with involved field radiation before chemotherapy. The median follow up for all 44 surviving patients was 31 months (range: 6-104 months). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 60% and 70%, respectively. The PFS and OS of patients who were treated with or without oral nitrosourea in addition to CHOP were 73% vs. 44% (P=0.035) and 75% vs. 64% (P=0.276), respectively. Nine patients with Stage IE or IIE diseases developed disease progression during their planned treatment and died within 10 months after the initiation of treatment; Six patients who achieved complete response (CR) after planned chemoradiation developed systemic recurrence and died at 13-48 months despite salvage treatment; one patient died of Hemophagocytic Syndrome during radiotherapy after achieving CR from chemotherapy. Three patients with Stage III or IV disease died during chemotherapy or during salvage treatment at 2, 4, and 19 months, respectively. Among the 59 patients who received chemotherapy as their initial treatment, 29, 6, 12, and 12 patients had complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) respectively after chemotherapy. The 2-year overall survival rates for these four groups of patients were 100%, 75%, 60%, and 17%, respectively (P<0.0001). Multivariate analysis revealed that International Prognostic Index (IPI) for Lymphoma, perforation of nasal septum as a presenting symptom, "B" symptoms, ECOG performance, as well as response after chemotherapy, were significant independent prognostic factors for this group of patients. The extent of response after induction chemotherapy is significantly related to the treatment outcome of patients with nasal NK/T-cell lymphoma. CHOP based chemotherapy combined with oral nitrosourea followed by involved field radiotherapy may provide improved treatment results compared to conventional CHOP chemotherapy and radiation. This strategy needs to be optimized and tested in a prospective trial for its efficacy.  相似文献   

18.
Seventeen patients with stage IA non-Hodgkin's lymphoma of the Waldeyer's ring were treated with radiation therapy with or without chemotherapy. All lesions were judged as having intermediate grade malignancy in the Working Formulation. Eight patients received combined treatment with three cycles of cyclophosphamide, doxorubicin, vincristine and prednison (CHOP) and radiation therapy with 30 to 40 Gy. Another 9 patients were treated with radiation therapy 40 to 60 Gy alone. After a median follow-up of 69 months, all 8 patients, treated with combined modality were alive and relapse-free, whereas 4 of the 9 treated with irradiation alone had relapsed. All relapses occurred transdiaphragmatically. Two of the 4 relapsing patients were saved, but the other two died of the disease. the 5-year relapse-free and cause-specific survival rates were 100% and 100% in the combined modality group, and 56% and 76% in the radiation therapy alone group (relapse-free: p = 0.04, cause-specific: p = 0.16). There were no serious complications related to treatment, although most patients complained of mouth dryness and most patients given CHOP had paresthesia. Our opinion was that the total impact of these two side-effects on quality of life was less pronounced after combined modality than after radiation therapy alone. Limited chemotherapy and radiation therapy seemed to be more beneficial than radiation therapy alone not only in relapse-free survival but also in quality of life after treatment.  相似文献   

19.
BACKGROUND: A limited number cycles of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy followed by involved field radiotherapy is the treatment of choice for Ann Arbor stage I intermediate or high grade non-Hodgkin's lymphomas (NHL). The optimal radiotherapy dose in this combined modality setting, resulting in maximal disease control with minimal toxicity is unknown. In this retrospective single-center study we evaluated the results of a combined modality treatment strategy that adapts the radiotherapy dose to the response after chemotherapy, and focus on the influence of radiotherapy dose on local control and survival. PATIENTS AND METHODS: One hundred and forty patients with NHL Ann Arbor stages I/IE of intermediate or high grade malignancy received four cycles of CHOP chemotherapy followed by involved field radiotherapy (IF-RT). The radiotherapy dose for patients in complete response (CR) after CHOP was either 26 or 40 Gy. Patients in partial response (PR) after CHOP always received 40 Gy. The influence of the radiotherapy dose on treatment outcome was evaluated for patients in CR at the end of treatment (n=128). RESULTS: CR rates after chemotherapy and after radiotherapy were 67 and 91%, respectively. Seventy-four of the patients in CR after CHOP received 26 Gy, 20 patients in CR after CHOP 40 Gy. All patients in PR after CHOP (n=34) received 40 Gy. The localization of relapse (within or outside the radiation field) did not differ between patients receiving 26 or 40 Gy. Overall survival (OS) at 5 years for patients in CR after CHOP who received 26 and 40 Gy and for patients in PR after CHOP but CR after 40 Gy IF-RT was 76, 100 and 75%, respectively, (P=0.16), disease free survival (DFS) at 5 years 69, 90 and 75%, respectively, (P=0.52). CONCLUSIONS: No statistically significant differences in patterns of relapse or survival were found between patients receiving 26 or 40 Gy IF-RT, however the number of events in all subgroups was small.  相似文献   

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