Prognosis and staging of primary bone lymphoma:an analysis of 40 patients / 中华放射肿瘤学杂志

ABSTRACT

Objective To retrospectively analyze the treatment outcomes and prognostic factors for primary bone lymphomas ( PBL) . Methods Forty patients with PBL who were admitted to our center from 1964 to 2014 were enrolled as subjects. In those patients, 10 were treated with chemotherapy alone, 10 with radiochemotherapy, 10 with postoperative chemotherapy, 9 with postoperative radiochemotherapy, and 1 with surgery alone. The median radiation dose was 36 Gy. The Kaplan?Meier method was used to calculate survival rates . The log?rank test was used for survival difference analysis and univariate prognostic analysis . Results The follow?up rate was 100%. The 3?year sample size was 36. In all patients, the 1?and 3?year overall survival rates were 60% and 42%, respectively, while the 1?and 3?year disease?free survival rates were 45%and 34%, respectively. The univariate analysis showed that no pathological fracture at diagnosis, normal lactate dehydrogenase level, an International Prognostic Index score of ≤1, early clinical stage ( stageⅠE ) , complete response after initial treatment, no less than 6 cycles of chemotherapy, a radiation dose of≥40 Gy, no progression outside radiation field after radiotherapy, and grade<3 bone marrow suppression during the treatment were prognostic factors for survival ( P=0. 027, 0. 037, 0. 000, 0. 016, 0. 000, 0. 000, 0. 022, 0. 014, and 0. 030). Conclusions The incidence of PBL is low. Comprehensive treatment can achieve satisfactory outcomes. As a PBL staging system, Ann Arbor has limitations. The staging of PBL should be based on local bone destruction and metastasis.