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目的 分析Ⅰ期非霍奇金淋巴瘤疗后复发病例再治疗的结果及可能与预后有关的因素。方法 本院收治的 187例Ⅰ期NHL随诊发现 38例出现疗后复发。病理类型为低度恶性 2例 ,中度恶性 16例 ,高度恶性 19例 ,未分类型 1例。首程治疗距复发的间隔时间 2 2例 (5 7.9% ) <2 4个月 ,16例≥ 2 4个月 ,中位复发时间为 2 1个月。原发部位复发 8例 ,远处孤立性复发病灶 16例 ,广泛播散性复发 14例。再程治疗情况 :放射治疗 3例 ,化疗 16例 ,化疗 +放射治疗 9例 ,5例复发后未接受再程治疗 ,4例复发后是否治疗不详 ,1例复发后失随。应用Kaplan Meier方法进行生存分析 ,Logrank方法进行差异检验。结果 全组病例复发后 1、3年生存率分别为 73.5 %、48.3%。复发后接受治疗的2 8例 ,复发后 1、2、3年生存率分别为 88.5 %、6 0 .5 %、5 4.5 %。首程治疗距复发的间隔时间 <2 4个月2 2例 ,1、2年生存率分别为 6 7.5 %、42 .8% ;≥ 2 4个月 16例 ,1、2年生存率分别为 80 .0 % ,6 4.0 % ,二者差异无显著性意义 (P >0 .0 5 )。远处单发病灶复发 16例 ,1、2年生存率分别为 78.8% ,70 .0 % ;广泛播散性复发 14例 ,1、2年生存率分别为 49.0 %、32 .7% ,二者差异有显著性意义 (P <0 .0 5 )。结论 Ⅰ期NHL治疗后复发病例经积极补救治
Objective To analyze the results of retreatment of relapsed cases after treatment in stage I non-Hodgkin’s lymphoma and the possible prognostic factors. Methods A total of 187 patients with stage I NHL admitted to our hospital were found to have relapsed after treatment. The pathological types were low-grade malignancy in 2 cases, moderate malignancy in 16 cases, high-grade malignancy in 19 cases, and undifferentiated type in 1 case. The interval between first treatment and recurrence was 22 cases (5 7.9%) <2 4 months, 16 cases were ≥ 24 months, and the median recurrence time was 21 months. 8 cases of primary site recurrence, distant recurrent lesions in 16 cases, 14 cases of extensive disseminated recurrence. Remission treatment: radiation therapy in 3 cases, chemotherapy in 16 cases, chemotherapy + radiation therapy in 9 cases, 5 cases did not receive relapse after relapse treatment, 4 cases of recurrence after treatment is unknown, 1 case of relapse after relapse. Kaplan Meier method was used for survival analysis and Logrank method was used for difference test. Results The 1-year and 3-year survival rates of the whole group after relapse were 73.5 % and 48.3 % respectively. Among the 28 patients who received treatment after relapse, the 1-, 2-, and 3-year survival rates after relapse were 88.5 %, 60.5%, and 54.5%, respectively. The interval between first treatment and recurrence interval was 22 months, 22 cases, 1 and 2 year survival rates were 67.5 % and 42.8% respectively; ≥ 2 4 months 16 cases, 1 and 2 year survival rates were 80.0%, 6 4.0%, the difference was not significant (P > 0.05). There were 16 single-site recurrences in distant sites, with 1-year and 2-year survival rates of 78.8% and 70.0%, and 14 cases with extensive disseminated recurrences. The 1 and 2-year survival rates were 49.0 % and 32.7%, respectively. The difference was significant (P < 0.05). Conclusion Relapsed cases after stage I NHL treatment are actively remedied