I, II기 원발성 위장관 임파종의 수술후 방사선 치료

Combined Surgery and Radiotherapy in the Stage I and II Primary Gastrointestinal Non-Hodgkin's Lymphomas

I, II기 원방성 위장관 임파종 환자 38명의 수술후 방사선 치료 결과를 분석하였다. 방사선 치료 중 6예의 원격전이가 관찰되었고, 방사선 치료 전 병소의 크기에 따른 치료실패율은 5cm 미만에서 $31\%$, 5cm 이상에서 $75\%$로 유의한 차이가 있었다(p<0.05). 방사선 치료를 계획대로 받은 28예서 5년 생존율은 $69.2\%$였고, 그중 병소의 크기가 5cm 미만인 경우는 $72\%$였다. 병소의 크기에 따른 5년 무병생존율에도 차이가 있어 5cm 미만인 경우엔 $71\%$, 5cm 이상인 경우엔 $25\%$였다(p<0.05). 반면에 병기, 병리학적 유형 및 원발장기 등에 따른 생존율의 차이는 유의하지 않았다. 따라서 방사선 치료 전 병소 크기가 5cm 미만일 경우는 완치가 가능하나, 5cm 이상으로 클 경우에는 항암화학요법의 병용이 시도될 수 있겠다.

Thirty eight patients with stage I and II primary gastrointestinal non-Hodgkin's lymphoma were treated in the Department of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1984. There were 6 systemic disseminations during radiotherapy, and the overall failure rate were $31\%$ in the cases with tumor bulk less than 5cm in diameter before radiotherapy and $75\%$ in the cases with tumor bulk greater than 5cm in diameter (p <0,05). The overall 5 year survival rate were $69.2\%$ in 28 patients who completed radiotherpay and $72\%$ in 24 patients with tumor bulk less than 5cm in diameter (small or no tumor bulk). The 5 year disease free survival rate were $71\%$ in cases with tumor bulk less than 5cm in diameter and $25\%$ in cases with tumor bulk greater than 5cm in diameter (p<0.01). But the intitial stage was not related with treatment result in all cases or subgroups of cases. Thus the cases with small or no tumor bulk were shown to be curable with combined surgery and postoperative radiotherapy, but for the control of the cases with large tumor bulk that had a guarded prognosis combined radiotherapy and chemotherapy should be tried.