摘要
中国医学科学院肿瘤医院自１９７８年１月至１９８７年１２月共收治非何杰金氏淋巴瘤（ＮＨＬ）病例８３８例，年龄≥６０岁者１２３例，占１４．７％。病理类型低、中、高度恶性型分别为１２例（９．８％），６６例（５３石％），２９例（２３．６％），未分类型１５例（１２．２％），浆细胞肉瘤１例。临床分期Ⅰ期４０例（３２．５％），Ⅱ期３２例（２６．０％），Ⅲ期２５例（２０．３％），Ⅳ期２６例（２１．１％）．２１例（１７．１％）伴有全身症状。Ⅰ期采用单纯放疗，放疗技术为扩大野照射。Ⅱ期病例中，单纯放疗１７例，放疗加化疗１５例。Ⅲ、Ⅳ期患者以化疗为主，部分病例合并局部放疗。Ⅰ、Ⅱ和Ⅲ＋Ⅳ期疗后五年生存率分别为７４．８％、３４．４％、１３．１％，统计学处理Ｐ＜０．０５。病理低、中、高度恶性疗后５年生存率分别为５８．３％、３２．％、３６．９％、Ｐ值＞０．０５．本文认为对老年Ⅰ期ＮＨＬ病例，单纯放疗可使大部分病例获得治愈。因老年患者对化疗的耐受性差，是否合并化疗应慎重考虑。Ⅱ期病例治疗失败的主要原因是播散性复发（１３／１８）。对Ⅱ期病例宜采用综合治疗。Ⅲ、Ⅳ期的治疗在患者条件许可的情况下尽可能给予足量化疗。重视支持疗法及合并症的治疗也?
Abstract123 patients aged 60 years or lnore with non-Hodgkin’s lymphoma(NHL)are reported.These patients formed 14.7%of 838 consecutive cases of NHL seen in our hospital in a 10 year period.107 of the 123 patients were histologically classifiable according to the International Working Formulation of NHL:low-grade 12 cases,intermediate 66 cases and high grade 29 cases.Clinical stages were 40 stage Ⅰ,32 stage Ⅱ,25 stage Ⅲ,and 26 stage Ⅳcases.21 patients had systemic symptoms.Stage Ⅰ patients were treated with radiotherapy alone,17 stage Ⅱ patients byradiotherapy alone and 15 patients by radiotherapy plus chemotherapy. Stage Ⅲ and Ⅳ patientswere treated with chemotherapy,Five year survival rates ofstage Ⅰ,Ⅱand Ⅲ+Ⅳ were 74.8%, 34.4%and 13.17%,respectively (P<0.05). Five year survival rates of different histological subtypeswere 58.3%, 32%, 36.9%for low,intermediate and high grades (P>0.05).Radiotherapy is indicatedfor stage Ⅰ patients. Chemotherapy should be used cautiously because of severe toxic response inthe elderly,Combination management is indicated for stage Ⅱ patients for its tendencv towardsdissemination,Full dose chemotherapy is suggested for stagemand Ⅳ patients.
出处
《中华放射肿瘤学杂志》
CSCD
1994年第3期169-171,217,共4页
Chinese Journal of Radiation Oncology
