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背景和目的:鼻咽是较常见的非霍奇金淋巴瘤结外侵犯部位,但其标准的治疗方法目前仍未确定。本文拟分析有关资料,探讨鼻咽非霍奇金淋巴瘤的临床特征及治疗策略。方法:收集1976年6月至2001年8月在中山大学肿瘤医院收治的75例鼻咽非霍奇金淋巴瘤患者的临床资料,回顾性分析其临床特点和治疗方式对患者生存期的影响。结果:鼻咽非霍奇金淋巴瘤临床分期大多为Ⅰ～Ⅱ期(占90.8%),病理类型按工作分型多为中度恶性(占95.2%),免疫分型以B细胞为主(占68.6%)。本组患者采用化放疗联合治疗47例(62.7%)、单纯化疗19例(25.3%)、单纯放疗9例(12.0%),总的2、5和10年生存率分别为79.1%、69.8%和64.3%,正规CHOP方案化疗加或不加局部放疗者54例,总的2、5和10年生存率均为84.6%。然而,单纯局部放疗患者生存率低,5年生存率为0。CHOP方案化疗加或不加局部放疗者,5年生存率无显著性差异(74.1%vs77.0%),局部放射剂量≤50Gy者与>50Gy者5年生存率亦无显著性差异(60.0%vs58.7%)。结论:鼻咽非霍奇金淋巴瘤在治疗上应以含CHOP方案的全身化疗为主;是否需要加用局部放疗以及最佳放射剂量,尚需前瞻性随机研究证实。
BACKGROUND & OBJECTIVE: Nasopharynx is the most common extranodal site of non-Hodgkin’s lymphoma, but its standard treatment has not been established. This article intends to analyze the relevant data to explore the clinical features of nasopharyngeal non-Hodgkin’s lymphoma and treatment strategies. Methods: The clinical data of 75 patients with nasopharyngeal non-Hodgkin’s lymphoma who were admitted to Cancer Hospital of Sun Yat-sen University from June 1976 to August 2001 were retrospectively analyzed. The clinical characteristics and the effect of treatment on survival were collected. Results: Most of the clinical stages of nasopharyngeal non-Hodgkin’s lymphoma were stage Ⅰ-Ⅱ (90.8%). Most of the pathological types were moderately malignant (95.2%), and the immunophenotypes were mainly B cells Accounting for 68.6%). In this group, 47 patients (62.7%) were treated with combined chemoradiotherapy, 19 (25.3%) with chemotherapy alone and 9 (12.0%) with radiotherapy alone. The overall 2,5 and 10 year survival rates were 79.1% and 69.8% And 64.3% of the patients in the regular CHOP regimen chemotherapy plus or without local radiotherapy 54 cases, the total 2,5 and 10-year survival rates were 84.6%. However, the survival rate of patients with simple local radiotherapy is low, 5-year survival rate was 0. There was no significant difference in 5-year survival rate between CHOP regimen with or without local radiotherapy (74.1% vs77.0%), 5-year survival rate with local radiotherapy dose less than 50 Gy and> 50 Gy (60.0% vs58.7%). CONCLUSIONS: Nasopharyngeal non-Hodgkin’s lymphoma should be treated with systemic chemotherapy with CHOP regimen. The need for local radiotherapy plus optimal radiation dose should be confirmed by prospective randomized studies.