Prognostic factors in patients with primary non-Hodgkin's lymphoma of the tonsil / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the prognostic value of the size of primary tumor (T staging) and international prognostic index (IPI) for patients with non-Hodgkin's lymphoma (NHL) of the tonsil, and to recommend the treatment strategy for early stage patients.</p><p><b>METHODS</b>306 patients with untreated NHL of the tonsil were reviewed. According to Ann Arbor staging classification, 35 patients had stage I, 178 stage II, 49 stage III and 44 stage IV disease. According to 1997' AJCC staging system, 29 patients had T1, 142 T2, 117 T3 and 18 T4 disease. Twelve stage I patients were given radiotherapy alone and 23 stage II patients were given combined modality therapy (CMT). For patients with stage II lesion, 57 were given radiotherapy alone, 2 chemotherapy alone and 119 CMT. Chemotherapy was the main treatment in patients with stage III or IV lesions.</p><p><b>RESULTS</b>The 5-year cancer specific survival (CSS) was 74% for patients with T(1), 59% for T(2), 56% for T(3) and 26% for T(4), respectively (P = 0.000). The 5-year CSS was 70% for patients with 0 risk factor, 49% for 1 risk factor, 25% for 2 or 3 risk factor, respectively (P = 0.000). CMT significantly improved disease free survival (DFS) from 46% (radiotherapy alone) to 60% (CMT) for stage II patients (P = 0.046). Multivariate analysis showed that performance status, Ann Arbor staging, T staging, B symptom, and IPI were independent prognostic factors.</p><p><b>CONCLUSION</b>The T staging of the primary tumor and IPI are the important prognostic factors of patients with NHL of the tonsil. Combined modality therapy significantly improves the disease free survival of stage II patients.</p>

Radiotherapy of adult early-stage Hodgkin's disease / 中华放射肿瘤学杂志

Objective　To define the rational extent of radiation portal in adult patients with early-stage Hodgkin's disease (HD).Methods　From Jan 1984 to Dec 1997,206 adult(≥15 year-old) HD patients with stage Ⅰ～Ⅱ lesions were admitted into the cancer hospital of Chimese Academy of Medical Sciences. 130 cases received radiotherapy alone (RT group). 76 cases radiotherapy combined with chemotherapy (R+C group). Involved-field (IF) was used in 7 patients (3.4%),mantle-field(MF) in 34 (16.5%) patients,subtotal nodal irradiation (STNI) in 140 (68.0%) and total nodal irradiation (TNI) in 25 (12.1%) patients. Kaplan-Meier method was used in survival analysis and log rank test for comparson.Results　①The overall 5-,10-year accumulated survival rates (ASR) were 85.1% and 73.2%. The 5-,10-year disease free survival rates (DFSR) were 68.0% and 63.6%, respectively.② The 5-year ASRs in the MF,STNI and TNI groups were 69.2%,93.3% and 94.4%,respectively (P<0.05)；the 5-year DFSRs in these respective groups were 54.2%,79.2% and 79.9% (P<0.05).③ In R+C patients ,the 5-ASRs in the IF/MF and STNI/TNI groups were 75.7% and 90.6%(P<0.05); 5-year DFSRs were 43.1% and 73.3%(P<0.05).Conclusions　The stage ⅠA patients with favouable prognostic factors can be cured by using mentle-field only,but patients in the other early-stages should be given subtotal nodal irradiatiion when radiotherapy is given alone. It is suggested that patients with unfavorable prognostic factors should receive radiotherapy combined with chemotherapy.

Analysis of prognostic factors in primary gastrointestinal non-Hodgkin's lymphoma: A study of 54 patients / 中华放射肿瘤学杂志

Purpose: To analyze the treatment results and detect the prognostic factors for primary gastrointestinal non-Hodgkin'slymphoma (PG-NHL) treated by various treatments. Materials and Methods: 54 PG-NHL patients (19 stage Ⅰ,23 stage Ⅱ, 6 stage Ⅲ and 6 stage Ⅳ patients) were treated from 1983 through 1992. After exploratory,45 patients had gastrotomy and 7, laparotomy. 43 patients were treated by postoperative radiotherapy or chemotherapy or both. Results: The 5-year survival rates ofⅠ～Ⅳ stage were: 94.7%?13.5% ,79.1%?12%, 80%?25.3% and 16.7%? 15.2%. The prognostic factors in PG-NHL were clinical pathologic stages, the volume of the primary tumor and single or multiple foci. Conclusion: Adequate initial surgery combined with postoperation adjunctive R in the upper abdomen for early stage Ⅰ and total abdomen for late stage Ⅰ and Ⅱ, which could be combination C+R following the incomplite resection or unresectable lesions , the tumor dose were 40～45Gy/5～6 wks and the CHOP- BLM program 4～ 6 cyles are benefit for PG-NHL.