李春艳, 郭 晔. Clinical characteristics and therapeutic status of primary Waldeyer’s ring non-Hodgkin’s lymphoma[J]. China Oncology, 2018, 28(4): 315-320. DOI: 10.19401/j.cnki.1007-3639.2018.04.012.
韦氏环是一个环形淋巴组织区域,主要包括鼻咽、口咽、扁桃体、舌根、下咽,是头颈部非霍奇金淋巴瘤最常累及的部位,其中最常见的组织学亚型是弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)。原发性韦氏环非霍奇金淋巴瘤(non-Hodgkin’s lymphoma,NHL)由于解剖部位的缘故具有独特的临床特点,其诊治可部分参照其他结内NHL。根据历年文献报道,国际预后指数(International Prognostic Index,IPI)及行为状态(performance status,PS)、年龄、分期、病理类型、治疗方案等均可能影响患者预后。局限期患者可联合局部放疗,广泛期患者以全身化疗为主。目前局限期韦氏环DLBCL患者的标准化疗方案是R-CHOP,但后续是否需要联合放疗尚无统一标准。由于系统治疗的发展,对于局限期患者特别是治疗后达到完全缓解(complete response,CR)的患者,是否可以省略后续的放疗将成为一个重要的研究课题。
Abstract
Waldeyer’s ring is a circular band of lymphoid tissue which is mainly composed of nasopharynx
oropharynx
tonsils
tongue base and hypopharynx. It is the most common site of non-Hodgkin’s lymphoma (NHL) in the head and neck
and the most common histologic subtype is diffuse large B-cell lymphoma (DLBCL). Because of the special anatomical structure
primary Waldeyer’s ring NHL has some unique clinical features. The diagnosis and treatment can partially refer to other nodal NHL. According to the literature reported in the past years
the international prognostic index (IPI)
performance status (PS)
age
stage
pathological type
treatment options may impact on the prognosis of the patients. Patients with limited stage could be treated with local radiotherapy. Systematic chemotherapy is widely used in patients with extensive stage. At present
for the patients with localized Waldeye's ring DLBCL
R-CHOP is the standard treatment
but there is no consensus about whether they should receive radiotherapy after immunochemotherapy. Due to the development of systematic treatment
whether subsequent radiotherapy can be omitted for patients with localized disease
especially for patients who have achieved complete response after immunochemotherapy