- 作者：Naoki Hashimoto ; M.D.&lowast ; ; Ryohei Sasaki ; M.D.&lowast ; ; rsasaki@med.kobe-u.ac.jp ; Hideki Nishimura ; M.D.&lowast ; ; Kenji Yoshida ; M.D.&lowast ; ; Daisuke Miyawaki ; M.D.&lowast ; ; Masao Nakayama ; M.S.&lowast ; ; Kazuyuki Uehara ; M.S.&lowast ; ; Yoshiaki Okamoto ; M.D.&lowast ; ; Yasuo Ejima ; M.D.&lowast ; ; Atsushi Azumi ; M.D.&dagger ; ; Toshimitsu Matsui ; M.D.&Dagger ; ; Kazuro Sugimura ; M.D.&lowast ;
- 关键词：MALT lymphoma ; Ocular adnexal lymphoma ; Radiotherapy ; Pattern of failure
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 出版时间：15 March, 2012
- 年：2012
- 卷：82
- 期：4
- 页码：1509-1514
- 全文大小：196 K
Purpose
To evaluate the long-term treatment outcome and disease behavior of primary ocular adnexal MALT (mucosa-associated lymphoid tissue) lymphoma (POAML) after treatment with radiotherapy.Methods and Materials
Seventy-eight patients (42 male, 36 female) diagnosed with stage I POAML between 1991 and 2010 at Kobe University Hospital were included. The median age was 60 years (range, 22-85 years). The median radiation dose administered was 30.6 Gy. Rituximab-based targeted therapy and/or chemotherapy was performed in 20 patients (25.6 % ). Local control (LC), recurrence-free survival (RFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method.
Results
The median follow-up duration was 66 months. Major tumor sites were conjunctiva in 37 patients (47.4 % ), orbita in 29 (37.2 % ), and lacrimal glands in 12 (15.4 % ). The 5- and 10-year OS rates were 98.1 % and 95.3 % , respectively. The 5- and 10-year LC rates were both 100 % , and the 5- and 10-year RFS rates were 88.5 % and 75.9 % , respectively. Patients treated with a combination of radiotherapy and targeted therapy and/or chemotherapy had a trend for a better RFS compared with those treated with radiotherapy alone (p?= 0.114). None developed greater than Grade 2 acute morbidity. There were 14 patients who experienced Grade 2 morbidities (cataract: 14; retinal disorders: 7; dry eye: 3), 23 patients who had Grade 3 morbidities (cataract: 23; dry eye: 1), and 1 patient who had Grade 4 glaucoma.
Conclusions
Radiotherapy for POAML was shown to be highly effective and safe for LC and OS on the basis of long-term observation. The absence of systemic relapse in patients with combined-modality treatment suggests that lower doses of radiation combined with targeted therapy may be worth further study.