Early primary pulmonary mucosa-associated lymphoid tissue lymphoma:a prognostic analysis and literature review / 中华放射肿瘤学杂志

ABSTRACT

Objective To analyze the clinical features,treatment methods,and prognostic factors for early primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma.Methods A retrospective analysis was performed on the clinical data,treatment outcomes,and survival of 32 patients with early pulmonary MALT lymphoma from March 2001 to September 2013.The median age of those patients was 56 years.Twenty-three patients had stage ⅠE disease and nine had stage Ⅱ E disease.According to the marginal zone B-cell lymphoma prognostic index (MZLPI),twenty-three patients were scored as 0 and nine as 1.Nine patients received radiotherapy,eight patients underwent surgery alone,three patients underwent surgery plus chemotherapy,and twelve patients received chemotherapy alone.The Kaplan-Meier method was adapted for calculating the OS,PFS and the log-rank test was used for survival difference analysis and univariate prognostic analysis.Results The 5-year sample size was 22.The 5-year overall survival (OS) and progression-free survival (PFS) rates were 84.5％ and 73.2％,respectively.Radiotherapy yielded an overall response rate of 100％,including a complete response rate of 66.7％ and a partial response rate of 33.3％.The univariate analysis showed that non-radiotherapy treatment was a prognostic factor for poor PFS.The patients treated with radiotherapy had significantly higher 5-year PFS rates than those treated without radiotherapy (100％ vs.63.0％,P=0.029),while there was no significant difference in 5-year OS rate between these two groups (100％ vs.78.8％,P=0.129).Age older than 60 years,an ECOG score of 2,and an MZLPI score of 1 were prognostic factors for poor PFS (P=0.041,0.018,and 0.044) and OS (P=0.001,0.001,and 0.003).Conclusions The prognostic factors for early pulmonary MALT lymphoma include age,ECOG score,and MZLPI score.Low-dose involved-field radiotherapy (24-30 Gy) can improve local control and survival.