CAJ | 학술논문

目的分析青少年儿童原发系统性间变大细胞淋巴瘤(ALCL)患者接受CHOP方案化疗±受累野放疗的疗效.方法回顾分析本院1998-2010年收治的28例青少年、儿童ALCL患者资料.Ⅰ、Ⅱ期12例中单纯化疗2例、综合治疗10例,Ⅲ、Ⅳ期16例中单纯化疗14例、综合治疗2例.CHOP方案15例、CHOP联合其他高强度化疗13例.化疗周期数3～17个(中位数6个).放疗多为受累野照射,剂量39.6～ 50.0 Gy(中位数45 Gy).结果全组患者首程疗后达CR者25例(89％),3例病变进展.中位随访时间45.3个月.全组5年无事件生存率为80％,5年OS为93％.疗终达CR者5年OS为100％,而未达CR者无5年OS(P=0.000).≥2个结外器官受侵者5年无事件生存率为38％,而＜2个结外器官受侵者的为85％ (P =0.010).结论青少年、儿童原发系统性ALCL按成人方案治疗效果满意,但还需要长期随访.
목적 분석청소년인동원발계통성간변대세포림파류(ALCL)환자접수CHOP방안화료±수루야방료적료효.방법 회고분석본원1998-2010년수치적28례청소년、인동ALCL환자자료.Ⅰ、Ⅱ기12례중단순화료2례、종합치료10례,Ⅲ、Ⅳ기16례중단순화료14례、종합치료2례.CHOP방안15례、CHOP연합기타고강도화료13례.화료주기수3～17개(중위수6개).방료다위수루야조사,제량39.6～ 50.0 Gy(중위수45 Gy).결과 전조환자수정료후체CR자25례(89％),3례병변진전.중위수방시간45.3개월.전조5년무사건생존솔위80％,5년OS위93％.료종체CR자5년OS위100％,이미체CR자무5년OS(P=0.000).≥2개결외기관수침자5년무사건생존솔위38％,이＜2개결외기관수침자적위85％ (P =0.010).결론 청소년、인동원발계통성ALCL안성인방안치료효과만의,단환수요장기수방.
Objective To investigate the long-term efficacy of CHOP (cyclophosphamide,doxorubicin,vincristine,and prednisone)-based chemotherapy alone or combined with regional radiotherapy for adolescent/childhood primary systemic anaplastic large-cell lymphoma (ALCL).Methods A retrospective analysis was performed on the medical records of 28 patients not older than 21 years with a confirmed diagnosis of primary systemic ALCL,who were admitted to our hospital from January 1998 to December 2010.Of 12 stage Ⅰ / Ⅱ patients,2 received chemotherapy alone,and 10 received chemotherapy and radiotherapy;of 16 stage Ⅲ/Ⅳ patients,14 received chemotherapy alone,and 2 received chemotherapy and radiotherapy.CHOP regimen was adopted in 15 patients,and CHOP regimen combined with other highintensity regimens was adopted in 13 patients.There were 3-17 chemotherapy cycles (median:6 cycles).Radiotherapy was performed mainly by involved field radiation,with a dose of 39.6-50.0 Gy (median:45 Gy).Results After the first course of treatment,25 (89％) of all patients achieved a complete remission (CR),and 3 patients experienced disease progression.With a median follow-up of 45.3 months,the 5-year event-free survival (EFS) and overall survival (OS) for all patients were 80％ and 93％,respectively.The 5-year OS was 100％ for patients achieving a CR after treatment,versus 0％ for those not achieving a CR (P =0.000).The 5-year EFS was 38 ％ for patients with involvement of ≥ 2 extranodal organs,versus 85 ％ for those with involvement of ＜ 2 extranodal organs (P =0.010).Conclusions CHOP chemotherapy combined with regional radiotherapy (for patients with localized disease) is an effective treatment for adolescent/childhood primary systemic ALCL,but long-term follow-up is needed to investigate treatmentrelated toxicities.