Radiation Therapy Results of the Non-Hodgkin's Lymphoma of the Sinonasal Cavity

비강 및 부비동 Non-Hodgkin's Lymphoma의 방사선 치료

From January 1970 through December 1984, 15 patients with sinonasal Non-Hodgkin's lymphoma combined to the head and neck were treated by external irradiation.13 patients were stage It and 2 were stage IIE by Ann Arbor Classification. However, when using TNM system, 7 were locally advanced T3, T4 lesions. All patients had follow up from 3.7 to 16 years with the median follow-up of 8.5 years. The overall actuarial 5-year survival rates were $25\%,\;28\%$ for IE and $0\%$ for IIE. Total tumor dose varied from 40 to 68 Gy. $100\%$ complete response with a total tumor dose of more than 55 Gy and $73\%$ complete response with less than 55Gy. When the disease was staged using the TNM (AJC) system, the five-year disease free survival for T1 and T2 patients was $50\%$ as compared with $14\%$ for T3 and T4. Failure rate by stage was $33\%(2/6)$ for T1 and T2, $86\%(6/7)$ for T3 and T4, and $100\%$(2/2) for IIE. The results suggest that 1. Higher CR could be obtained with a total tuner dose of more than 55 Gy. 2. Use of TNM staging system is as important as Ann arbor in management of sinonasal NHL. 3. The addition of combination chemotherapy should be considered for T3, T4 and IIE the sinonasal Non-Hodgkin's lymphoma although the disease is limited to head and neck.

1970년부터 1980년까지 연세대학교 치료방사선과에서 방사선치료 받은 비강 및 부비동에 발생한 NHL환자 15예를 대상으로 후향성 분석을 하여 다음과 같은 결과를 얻었다. 1. 병기분포는 13예가 IE 2예가 IIE였고 TNM병기에 따르면 7예가 국소병변이 진행된 T3, T4 환자였다. 2. Overall 5년 생존율을 $25\%$, IE는 $28\%$, IIE는 $0\%$였다. 3. 병기별 치료실패율은 T1, T2는 $33\%(2/6),\; T3,\;T_4는\;86\%(6/7),\;IIE$에서는 $100\%(2/2)$였다. 4. 방사선 조사량이 55Gy 이상인 경우 $100\%$의 완전 관해율을 보였으며 55Gy이하인 경우 $73\%$의 완전 관해율을 보였다. 5. 비강 및 부비동의 NHL의 Ann Arbor병기 분류와 함께 TNM 병기도 예후에 중요한 요인이 될 것 같다. 6. 국소병변이 진행된 병기 T3, T4와 IIE 환자에서는 화학요법제의 병용치료가 필요할 것 같다.