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目的 分析肿瘤局部侵犯范围、全身化疗和放射治疗因素对鼻腔非霍奇金淋巴瘤预后的影响。方法 90例鼻腔非霍奇金淋巴瘤在本院行放射治疗和化疗综合治疗。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 5 4.0Gy(4 5 .2～ 71.5Gy)。颈部治疗性照射 16例 ,预防性照射 39例 ,均行全颈照射 ,35例未照射。化疗 :80例放射治疗前、中或后行COP、COPP、COMP、CHOP、COBDP方案或环甲亚硝脲化疗 2～ 6疗程 ,8例放射治疗或化疗前先行了手术切除。肿瘤局部侵犯范围分成 3个区 :Ⅰ区为病灶局限于鼻腔 (31例 ) ;Ⅱ区为病灶累及鼻腔及邻近一结构 (35例 ) ;Ⅲ区为累及鼻腔及邻近 2个或 2个以上结构 (2 4例 )。结果 本组病例中位生存期 5 8.7个月 ,5年总生存率为 46 .0 % ,无瘤生存率为 42 .5 % ,局部控制率为 92 .0 % ,远处侵犯率为 33.5 %。将肿瘤局部侵犯范围 (Ⅰ、Ⅱ、Ⅲ区 )等分别行单因素和多因素分析 ,结果显示肿瘤局部侵犯范围对总生存率、局部控制率和远处侵犯均有显著性影响。全身化疗单因素分析显示对生存率有显著性意义 (P <0 .0 5 ) ,多因素分析示对生存率可能有影响 (P =0 .0 5 6 ) ,两分析法均显示对远处侵犯有显著影响。结论 肿瘤局部侵犯范围是影响?
Objective To analyze the impact of local tumor invasion, systemic chemotherapy and radiotherapy on the prognosis of nasal non-Hodgkin’s lymphoma. Methods 90 cases of nasal non-Hodgkin’s lymphoma underwent radiotherapy and chemotherapy in our hospital. Radiation therapy: the main field of the nose before the “convex” word field, sub-single or bilateral ear field, who first involving the face and neck joint involving the wild. The median nasal target dose 5 4.0Gy (45.2 ~ 71.5Gy). 16 cases of therapeutic neck irradiation, 39 cases of prophylactic irradiation, were performed full neck irradiation, 35 cases were not irradiated. Chemotherapy: COP, COPP, COMP, CHOP and COBDP regimen were given in 80 cases before radiotherapy, in the middle or after radiotherapy, or 2 ~ 6 courses of chemotherapy with corangile nitrosourea. Surgical resection was performed in 8 cases before radiotherapy or chemotherapy. Local tumor invasion was divided into three regions: Ⅰ area was localized in the nasal cavity (31 cases); Ⅱ area involved the nasal cavity and adjacent structures (35 cases); Ⅲ area involved the nasal cavity and adjacent 2 or more than 2 structures (24 cases). Results The median survival time of this group was 57.7 months. The 5-year overall survival rate was 46.0%, the tumor-free survival rate was 42.5%, the local control rate was 92.0% and the distance violation rate was 33.5% . The single and multi-factor analysis of the extent of local tumor invasion (Ⅰ, Ⅱ and Ⅲ) showed that the extent of local tumor invasion had a significant effect on the overall survival rate, local control rate and distant invasion. Univariate analysis of systemic chemotherapy showed a significant (P <0.05) survival rate, and multivariate analysis showed a possible effect on survival (P = .056) Violations have a significant impact. Conclusion Local tumor invasion is the impact?