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目的 回顾性分析Ⅰ期韦氏环非霍奇金淋巴瘤 (NHL)的治疗结果 ,比较单纯放射治疗和综合治疗的优劣。方法 Ⅰ期韦氏环NHL 62例 ,LA 5 9例 ,IB 3例。按照美国国立癌症研究所的工作分类 ,B细胞 3 8例 ,T细胞 9例 ,其中低度恶性 3例 ,中、高度恶性 43例 ,未分类 15例。根据 1997美国癌症协会 (AJCC)TNM分期原则T114例 ,T2 2 6例 ,T3 5例 ,T417例。单纯放射治疗 3 1例 ,综合治疗3 1例。放射治疗多采用面颈联合野 ,中位剂量 5 5Gy。化疗以COMP和CHOP方案为主 ,于放射治疗前或 (和 )后 2～ 3周期。应用Kaplan—Meier方法进行生存分析 ,Logrank方法进行差异显著性检验。结果 单纯放射治疗、综合治疗的 5年、10年生存率分别是96 8%、80 5 %和 93 3 %、82 6%,差别无显著意义 (P =0 5 162 )。而 5年、10年无复发生存率分别是 87 1%、73 7%和 95 7%、95 7%,差别有显著意义 (P =0 0 0 7)。病理类型 ,T分期不是影响预后的主要因素。结论 Ⅰ期韦氏环NHL单纯放射治疗和综合治疗效果满意 ,5年生存率高达 90 %以上。综合治疗能改善无病生存率。病理类型 ,T分期对预后无明显影响。
Objective To retrospectively analyze the treatment outcome of stage I Wechsler non-Hodgkin’s lymphoma (NHL), and to compare the advantages and disadvantages of simple radiotherapy and comprehensive treatment. Method Ⅰ Wehrer ring NHL 62 cases, LA 5 9 cases, IB 3 cases. According to the classification of the work by the National Cancer Institute, 38 B cells and 9 T cells were detected. Among them, 3 were low grade, 43 were medium and high grade, and 15 were not classified. According to 1997 American Cancer Society (AJCC) TNM staging principle T114 cases, T2 2 6 cases, T3 5 cases, T417 cases. Simple radiotherapy 31 cases, 31 cases of comprehensive treatment. Radiation therapy more face and neck joint field, the median dose 5 5Gy. Chemotherapy with COMP and CHOP program based, before or after (and) 2 to 3 cycles. Survival analysis was performed by Kaplan-Meier method and difference significance test by Logrank method. Results The 5-year and 10-year survival rates were 96.8%, 80.5% and 93.3%, 82.6%, respectively, for radiotherapy. The difference was not significant (P = 0 5 162). The 5-year and 10-year recurrence-free survival rates were 87.1%, 73.7% and 95.7%, 95.7%, respectively, with significant difference (P = 0 0 0 7). Pathological type, T staging is not the main factor affecting the prognosis. Conclusion Wehsland ring NHL radiotherapy alone and comprehensive treatment of satisfactory results, 5-year survival rate as high as 90%. Comprehensive treatment can improve the disease-free survival rate. Pathological type, T stage had no significant effect on prognosis.