【摘要】 回顾分析了１９８６ 年４ 月至１９９８ 年４ 月住院治疗的９６ 例儿童非霍奇金淋巴瘤（ＮＨＬ） 的临床资料。第１ 阶段（１９８６年４ 月至１９９０ 年１２ 月） ，共２９ 例，采用ＣＯＰ、ＣＨＯＰ、ＣＯＭＰ方案治疗６～８ 个周期，有中枢神经侵犯者给予ＭＴＸ、ＤＸＭ 鞘内注射，每周１ 次。第２ 阶段（１９９１ 年１ 月至１９９８ 年４ 月），共６７ 例，采用ＣＨＯＰ、ＣＨＯＰ加ＶＰ１６ 治疗８～１２ 个周期，后改用ＣＴＸ＋ＶＣＲ 巩固治疗共１ ．５ ａ 至２ ａ，临床Ⅳ期或病理分类恶性度高者常规鞘内注射ＭＴＸ１２ ．５ ｍｇ／ｍ２（ 最大量１２ ．５ ｍｇ） ，ＤＸＭ５ ｍｇ，每周１ 次，连续４ 次，有中枢神经侵犯者，每周２ 次，待脑脊液转阴后改为每周１ 次。结果表明，儿童ＮＨＬ 多见于男性年长儿，高发年龄６～１３ 岁，Ⅲ、Ⅳ期患儿所占比例高（６７．７％） ，易侵犯骨髓（３３．３ ％） 及中枢神经（１３ ．５％ ），初诊到确诊时间平均为７３ ｄ，最长达１ａ 。第１ 阶段疗效为：ＣＲ３７ ．９％ ，５ａ 生存率为２０ ．０％ 。第２ 阶段疗效为：ＣＲ６２．７ ％ ，５ ａ 生存率４９ ．４％ 。Ⅰ、Ⅱ与Ⅲ、Ⅳ期的５ ａ 生存率分别为８５ ．５％ 和９．８ ％ ，有显著差异（Ｐ更多还原

【Abstract】 cases of children NHL from April 1986 to April 1998 were retrospectively studied.During first period(from April 1986 to December 1990),29 patients were treated with COP,COPP or COMP regimen for 6～8 cycles,intrathecal chemotherapy with methotrexate and dexamethesone was given once a week on patients with CNS involvement.During secood period(from January 1991 to April 1998),67 patients were treated with CHOP or CHOP plus VP 16 regimen for 8～1O cycles.Then,consolidation chemotherapy with CTX plus VCR was administered for 1.5～2 years,prophylactic intrathecal therapy with MTX.DXM was given routinely once a week in the patient with stage Ⅳ NHL or high grade NHL for four weeks.In the patient with CNS involvment,intrathecal therapy was given twice a week and after tumor cells were negative in CSF,intrathecal therapy was given once a week.NHL in elder male children was more common than others,peak age was between 6～13 years.Patients with stage Ⅲ、Ⅳ NHL accounted for 67.7%.Infiltration of the bone marrow was present in 33.3% patients.CNS involvement occurred in 13.5% patients.The longest time spending from the first visit to confirmed diagnosis was one year,average time was 73 days.Therapeutic results:during first period:CR 37.9%,5 years survival rate was 20.0%.Second period:CR 62.7%,5 years survival rate was 49.4%.5 years survivat rate in stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ NHL was 85.8%,9.8% respectively,there was significant difference between 5 years survival rate in Ⅰ,Ⅱ stage and Ⅲ,Ⅳ stage NHL(P<0.01).It suggested that the early diagnosis and early treatment will be very important in improving patient′s survival.更多还原