鼻腔鼻窦恶性淋巴瘤的临床特征及疗效观察

谢华; 于斌; 孙文忠; 秦卫红; 阙颖

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鼻腔鼻窦恶性淋巴瘤的临床特征及疗效观察

谢华 , 于斌 , 孙文忠 , 秦卫红 , 阙颖

文章导航 > 蚌埠医学院学报 > 2014, 39 > 11: (1497-1500)

引用本文:

Citation:

鼻腔鼻窦恶性淋巴瘤的临床特征及疗效观察

1. 广西壮族自治区柳州市人民医院耳鼻咽喉科, 545006;
2. 广西壮族自治区柳州市人民医院肿瘤放疗科, 545006

作者简介: 谢华(1979-),女,主治医师.

中图分类号: R733.4

Observation of the clinical features and treatment of malignant lymphoma of the nasal cavity and paranasal sinuses

1. Department of Otorhinolaryngology, Guangxi Liuzhou People's Hospital, Liuzhou Guangxi 545006, China;
2. Department of Radiation Oncology, Guangxi Liuzhou People's Hospital, Liuzhou Guangxi 545006, China
CLC number: R733.4

摘要: 目的:探讨鼻腔鼻窦恶性淋巴瘤的临床特征和不同治疗方法的疗效,为防治鼻腔鼻窦恶性淋巴瘤提供科学依据。方法:70例鼻腔鼻窦恶性淋巴瘤患者中,行放、化疗42例,放疗28例。化疗方案以CHOP为主,少数用B-CHOP方案。局部放疗者,用直线加速器照射40～60 Gy/3～5周。分析患者临床症状、体征、影像学、生化、病理、治疗和预后影响因素。结果:70例患者中男51例(72.9%),女19例(27.1%),Ⅰe和Ⅱe期56例(80.0%);单发鼻腔病灶55例(78.6%);病理分类以T细胞型为主;主要表现为鼻塞、流涕、肿胀和鼻衄等,其次为口腔和眼眶症状,并累及颈部;总体5年无病生存40例,无病生存率(DFR)为57.1%;接受放、化疗者5年生存30例,DFR为71.4%,而接受放疗者5年生存10例,DFR为35.7%,差异有统计学意义(P<0.01);Ⅰe期患者中接受放、化疗者5年生存21例,DFR为87.5%;而接受放疗者5年生存10例,DFR为55.6%,差异有统计学意义(P<0.05);在Ⅱe和Ⅲe～Ⅳ期患者中接受放、化疗者5年分别生存7例和2例;而接受放疗者均无5年生存者,差异均无统计学意义(P>0.05)。结论:临床分期和治疗方式是影响5年DFR的主要因素;CHOP方案联合放疗治疗鼻腔鼻窦恶性淋巴瘤可获得更好的预后,显著提高患者的5年DFR。
- 淋巴瘤 /
- 鼻腔 /
- 鼻窦 /
- 临床特征
Abstract: Objective: To explore the clinical characteristics and efficacy of different therapies for malignant lymphoma of the nasal sinus,and to provide scientific evidence for clinical management of the disease.Methods: Among the 70 patients with nasal sinus malignant lymphoma,42 patients underwent radiotherapy and chemotherapy,and 28 patients received radiotherapy only.Most of the patients were administered CHOP as their chemotherapy regimen,and the others received B-CHOP.Those who received local radio-therapy were performed the linear accelerator irradiation,and the radiological dose was 40~60 Gy for 3~5 weeks.The patients' clinical symptoms,signs,imaging information,biochemistry,pathology,treatment and prognostic factors were analyzed.Results: Of the 70 patients,51 were male(72.9%) and 19 female(27.1%);56 patients were at stageⅠe and stage Ⅱe(80.0%),and 55 patients had single nasal lesion(78.6%).T cell type was the major pathological classification;the main manifestations were stuffy nose,runny nose,swelling,epistaxis,oral and eye symptoms and even complaints in the neck.40 patients survived for 5 years without suffering,and the disease-free survival rate(DFR) was 57.1%.In the 5-year DFR,30 patients received both radiotherapy and chemotherapy,and 10 patients received chemotherapy only,with a DFR rate of 71.4% and 35.7%,respectively;The difference was statistically significant(P<0.01).In the patients at stage Ⅰe,21 cases received both radiotherapy and chemotherapy survived for 5 years and 10 cases received only radiotherapy survived for 5 years,with a DFR rate of 87.5% and 55.6%,respectively.The difference was statistically significant(P<0.05).7 patients at stage Ⅱe who received radiotherapy and chemotherapy survived for 5 years,while only 2 patients at stage Ⅲe～Ⅳ survived;the difference was not statistically significant(P>0.05).No patients at stage Ⅱe or Ⅲe～Ⅳ survived for 5 years among those who had received radiotherapy only.Conclusions: The clinical staging and treatment methods are the main factors affecting the 5-year DFR.The CHOP combined with radiotherapy could make a better prognosis,and significantly improve the 5-year DFR in patients with malignant lymphoma of the nasal cavity and paranasal sinuses.
- lymphoma /
- nasal cavity /
- paranasal sinuses /
- clinical features

[1]	Kim J,Kim EY,Lee SK,et al.Extranodal nasal-type NK/T-cell lymphoma:computed tomography findings of head and neck involvement[J].Acta Radiol,2010,51(2):164-169.
[2]	闻明,秦玉红,陈填.鼻腔鼻窦恶性淋巴瘤7例误诊误治临床分析[J].中国医师进修杂志,2009,32(34):173-177.
[3]	Kim YR,Kim JS,Min YH,et al.Prognostic factors in primary diffuse large B-cell lymphoma of adrenal gland treated with rituximab-CHOP chemotherapy from the Consortium for Improving Survival of Lymphoma(CISL)[J].J Hematol Oncol,2012,5(49):1-9.
[4]	Yang QP,Zhang WY,Yu JB,et al.Subtype distribution of lymphomas in Southwest China:analysis of 6 382 cases using WHO classification in a single institution[J].Diagn Pathol,2011,6(77):1-7.[5] Sharmaa A,Dandekara M,Deshmukha S,et al.Nasal extranodal natural killer T cell lymphoma:an atypical presentation[J].J Laryngol Otol,2011,125(11):1181-1184.
[5]	申花淑,朴东明.延边地区113例鼻腔鼻窦恶性肿瘤的临床病理分析[J].中国中西医结合耳鼻咽喉科杂志,2011,19(2):104-105.
[6]	Yun J,Kim SJ,Won JH,et al.Clinical features and prognostic relevance of ovarian involvement in non-Hodgkin's lymphoma:A Consortium for Improving Survival of Lymphoma(CISL)report[J].Leuk Res,2010,34(9):1175-1179.

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鼻腔鼻窦恶性淋巴瘤的临床特征及疗效观察

作者简介: 谢华(1979-),女,主治医师.

1. 广西壮族自治区柳州市人民医院耳鼻咽喉科, 545006;
2. 广西壮族自治区柳州市人民医院肿瘤放疗科, 545006

收稿日期: 2012-12-10

关键词:

淋巴瘤 /
鼻腔 /
鼻窦 /
临床特征

摘要: 目的:探讨鼻腔鼻窦恶性淋巴瘤的临床特征和不同治疗方法的疗效,为防治鼻腔鼻窦恶性淋巴瘤提供科学依据。方法:70例鼻腔鼻窦恶性淋巴瘤患者中,行放、化疗42例,放疗28例。化疗方案以CHOP为主,少数用B-CHOP方案。局部放疗者,用直线加速器照射40～60 Gy/3～5周。分析患者临床症状、体征、影像学、生化、病理、治疗和预后影响因素。结果:70例患者中男51例(72.9%),女19例(27.1%),Ⅰe和Ⅱe期56例(80.0%);单发鼻腔病灶55例(78.6%);病理分类以T细胞型为主;主要表现为鼻塞、流涕、肿胀和鼻衄等,其次为口腔和眼眶症状,并累及颈部;总体5年无病生存40例,无病生存率(DFR)为57.1%;接受放、化疗者5年生存30例,DFR为71.4%,而接受放疗者5年生存10例,DFR为35.7%,差异有统计学意义(P<0.01);Ⅰe期患者中接受放、化疗者5年生存21例,DFR为87.5%;而接受放疗者5年生存10例,DFR为55.6%,差异有统计学意义(P<0.05);在Ⅱe和Ⅲe～Ⅳ期患者中接受放、化疗者5年分别生存7例和2例;而接受放疗者均无5年生存者,差异均无统计学意义(P>0.05)。结论:临床分期和治疗方式是影响5年DFR的主要因素;CHOP方案联合放疗治疗鼻腔鼻窦恶性淋巴瘤可获得更好的预后,显著提高患者的5年DFR。

English Abstract

Observation of the clinical features and treatment of malignant lymphoma of the nasal cavity and paranasal sinuses

1. Department of Otorhinolaryngology, Guangxi Liuzhou People's Hospital, Liuzhou Guangxi 545006, China;
2. Department of Radiation Oncology, Guangxi Liuzhou People's Hospital, Liuzhou Guangxi 545006, China

Received Date: 2012-12-10

Abstract: Objective: To explore the clinical characteristics and efficacy of different therapies for malignant lymphoma of the nasal sinus,and to provide scientific evidence for clinical management of the disease.Methods: Among the 70 patients with nasal sinus malignant lymphoma,42 patients underwent radiotherapy and chemotherapy,and 28 patients received radiotherapy only.Most of the patients were administered CHOP as their chemotherapy regimen,and the others received B-CHOP.Those who received local radio-therapy were performed the linear accelerator irradiation,and the radiological dose was 40~60 Gy for 3~5 weeks.The patients' clinical symptoms,signs,imaging information,biochemistry,pathology,treatment and prognostic factors were analyzed.Results: Of the 70 patients,51 were male(72.9%) and 19 female(27.1%);56 patients were at stageⅠe and stage Ⅱe(80.0%),and 55 patients had single nasal lesion(78.6%).T cell type was the major pathological classification;the main manifestations were stuffy nose,runny nose,swelling,epistaxis,oral and eye symptoms and even complaints in the neck.40 patients survived for 5 years without suffering,and the disease-free survival rate(DFR) was 57.1%.In the 5-year DFR,30 patients received both radiotherapy and chemotherapy,and 10 patients received chemotherapy only,with a DFR rate of 71.4% and 35.7%,respectively;The difference was statistically significant(P<0.01).In the patients at stage Ⅰe,21 cases received both radiotherapy and chemotherapy survived for 5 years and 10 cases received only radiotherapy survived for 5 years,with a DFR rate of 87.5% and 55.6%,respectively.The difference was statistically significant(P<0.05).7 patients at stage Ⅱe who received radiotherapy and chemotherapy survived for 5 years,while only 2 patients at stage Ⅲe～Ⅳ survived;the difference was not statistically significant(P>0.05).No patients at stage Ⅱe or Ⅲe～Ⅳ survived for 5 years among those who had received radiotherapy only.Conclusions: The clinical staging and treatment methods are the main factors affecting the 5-year DFR.The CHOP combined with radiotherapy could make a better prognosis,and significantly improve the 5-year DFR in patients with malignant lymphoma of the nasal cavity and paranasal sinuses.