Radiation Therapy in Extranodal Non-Hodgkin's Lymphoma of the Head and NeckRadiation Therapy in Extranodal Non-Hodgkin's Lymphoma of the Head and Neck

頭頸部淋巴結外非何杰金氏淋巴癌之放射線治療

高忠恕(Chung-Shuh Kao) ； 詹建勝(Jian-Sheng Jan) ； 張慶雄(Ching-ilsiung Chang) ； 林進清(Jin-Ching Lin) ； 曾顯群(Hsien-Chun Tseng) ； 翁益強(Yih-Chyang Weng)

《放射治療與腫瘤學》 4卷2期 (1997/06) Pp. 77-84

https://doi.org/10.6316/TRO/199704(2)77

摘要

目的：研究各項有關頭頸部淋巴結外非何杰金氏淋巴癌之預後因數
材料與方法：自1984年6月至1992年4月，共有22位罹患淋巴結外非何杰金氏淋巴癌之病患於本科接受放射線治療。其中男性16位，女性6位，年齡介於14至79歲之間，追綜期間為6至133個月。使用之機器為鈷六十遠隔治療，6或10百萬伏特之直線加速器，放射治療總劑量為2998至7001 cGy。經由回溯整理其治療記錄及病歷來研究各項預後因數。
結果：本文分析相關之預後因數，發現腫瘤之分期(Ann Arbor stage)為影響預後之主要因素。整體之五年存活率為57％。治療失敗包括有八名病患發生遠端復發，三名病患在原發部位復發，以及一名病患在鄰近之淋巴結復發。主要死因為遠端復發。腫瘤分期第一期之五年存活期可達到88%，第二、三、四期之五年存活期則分別為53%,0%,0％。放射治療之急性副作用以黏膜及唾液腺為主。
結論：早期頭頸部淋巴結外非何杰金氏淋巴癌之治療以放射線治療可以獲得相當不錯的結果。至於其他預後因數之分析則有待未來更多資科收集。

關鍵字

預後因子 ； 急性副作用

並列摘要

Purpose: To evaluate a variety of disease- and treatment-related variables that influence the prognosis of extranodal non-Hodgkin's lymphoma of the head and neck.
Materials and Methods: From June 1984 to April 1992, 22 patients with extranodal non-Hodgkin's lymphoma of the hoad and neck area had received radiotherapy at Taichung Veterans General Hospital. There were 16 males and 6 females between 14 and 79 years of age. The follow-up period ranged from 6 to 133 months. All patients were treated with Co-60 teletherapy machine, 6 MV or 10 MV linear accelerator. The radiation dose ranged from 2998 to 7001 cGy (mean: 4609 cGy). Prognostic factors such as the Ann Arbor stage, pathologic grading, number of involved sites, Waldeyer's ring involvement, age, sex, extent of radiation field, radiation dose, and LDH level were analyzed by retrospective review of the medical records.
Results: The most common acute radiation reactions occurred at mucous membrane and salivary gland. The overall 5-year disease-specific survival rate was 57%. Treatment failures included distant relapse (8 patients), relapse in primary site (3 patients) and regional LN (1 patient). The major cause of death was distant relapse. The Ann Arbor stage was the only significant prognostic factor in this study. The 5-year disease-specific survival was excellent for stage I disease (88%) and the survival rates for stage II, Ill, and IV were 53%, 0%, and 0%, respectively.
Conclusion: Non-Hodgkin's lymphoma arising from extranodal sites in the head and neck area was uncommon. The most significant prognostic factor was extent of the disease (Ann Arbor stage). Proper management of patients with early stage non-Hodgkin's lymphoma of the head and neck area remains controversial. However, excellent survival for stage I non-Hodgkin's lymphoma in the head and neck arising from extranodal sites was achievable by radiation therapy in this study.

並列關鍵字

Prognostic factors ； Acute radiation toxicities