Abstract：
OBJECTIVE: Follicular lymphoma (FL) is one of the most common lymphoma. Occasionally, FL is associated with tumoral epidural compression and management of these patients remain poorly codified. This study aims to report incidence, clinical characteristics, management and outcomes of patients with FL and tumoral epidural compression.
METHODS: Observational, retrospective cohort study of adult patients with FL and epidural tumor compression, treated in a French Institute over the last 20 years (2000-2021).
RESULTS: Between 2000 and 2021, 1382 patients with FL were followed by the haematological department. Of them, 22 (1.6%) patients (16 men and 6 women) had follicular lymphoma with epidural tumor compression. At epidural tumor compression occurrence, 8/22 (36%) patients had a neurological clinical deficit (motor, sensory or sphincter function) and 14/22 (64%) had tumor pain. All patients were treated with immuno-chemotherapy; the main regimen being used was R-CHOP plus high dose IV methotrexate in 16/22 (73%) patients. Radiotherapy for tumor epidural compression was performed in 19/22 (86%) patients. With a median follow-up of 60 months (range=[1-216]), 5 year local tumor relapse free survival was achieved in 65% (95% CI 47-90%) of patients. The median PFS was of 36 months (95% CI 24-NA) and 5 years OS estimate was 79% (95% CI 62-100%). Two patients developed a relapse at a second epidural site.
CONCLUSIONS: FL with tumoral epidural compression reached 1.6% of all FL patients. Management based on immuno-chemotherapy with radiotherapy appeared to produce comparable outcomes with the general FL population.
METHODS: Observational, retrospective cohort study of adult patients with FL and epidural tumor compression, treated in a French Institute over the last 20 years (2000-2021).
RESULTS: Between 2000 and 2021, 1382 patients with FL were followed by the haematological department. Of them, 22 (1.6%) patients (16 men and 6 women) had follicular lymphoma with epidural tumor compression. At epidural tumor compression occurrence, 8/22 (36%) patients had a neurological clinical deficit (motor, sensory or sphincter function) and 14/22 (64%) had tumor pain. All patients were treated with immuno-chemotherapy; the main regimen being used was R-CHOP plus high dose IV methotrexate in 16/22 (73%) patients. Radiotherapy for tumor epidural compression was performed in 19/22 (86%) patients. With a median follow-up of 60 months (range=[1-216]), 5 year local tumor relapse free survival was achieved in 65% (95% CI 47-90%) of patients. The median PFS was of 36 months (95% CI 24-NA) and 5 years OS estimate was 79% (95% CI 62-100%). Two patients developed a relapse at a second epidural site.
CONCLUSIONS: FL with tumoral epidural compression reached 1.6% of all FL patients. Management based on immuno-chemotherapy with radiotherapy appeared to produce comparable outcomes with the general FL population.
摘要：
目的：滤泡性淋巴瘤（FL）是最常见的淋巴瘤之一。偶尔,FL与肿瘤硬膜外压迫有关，对这些患者的管理仍然缺乏编码。这项研究旨在报告发病率，临床特征,FL和肿瘤硬膜外压迫患者的治疗和结局。
方法：观察性，成人FL和硬膜外肿瘤压迫患者的回顾性队列研究，过去20年(2000-2021年)在法国研究所接受治疗。
结果：在2000年至2021年之间，血液科随访了1382例FL患者。其中,22例（1.6％）患者（男性16例，女性6例）有滤泡性淋巴瘤伴硬膜外肿瘤压迫。在硬膜外肿瘤压迫发生时，8/22（36％）患者存在神经系统临床缺陷（运动，感觉或括约肌功能）和14/22（64％）有肿瘤疼痛。所有患者均接受免疫化学疗法治疗；16/22（73％）患者中使用的主要方案是R-CHOP加高剂量IV甲氨蝶呤。19/22（86％）的患者进行了肿瘤硬膜外压迫的放射治疗。中位随访时间为60个月（范围=[1-216]），65％（95％CI47-90％）的患者实现了5年局部肿瘤无复发生存率。中位PFS为36个月（95%CI24-NA），5年OS估计值为79%（95%CI62-100%）。两名患者在第二个硬膜外部位复发。
结论：肿瘤硬膜外压迫的FL达到所有FL患者的1.6％。基于免疫化疗和放疗的管理似乎产生了与一般FL人群相当的结果。
方法：观察性，成人FL和硬膜外肿瘤压迫患者的回顾性队列研究，过去20年(2000-2021年)在法国研究所接受治疗。
结果：在2000年至2021年之间，血液科随访了1382例FL患者。其中,22例（1.6％）患者（男性16例，女性6例）有滤泡性淋巴瘤伴硬膜外肿瘤压迫。在硬膜外肿瘤压迫发生时，8/22（36％）患者存在神经系统临床缺陷（运动，感觉或括约肌功能）和14/22（64％）有肿瘤疼痛。所有患者均接受免疫化学疗法治疗；16/22（73％）患者中使用的主要方案是R-CHOP加高剂量IV甲氨蝶呤。19/22（86％）的患者进行了肿瘤硬膜外压迫的放射治疗。中位随访时间为60个月（范围=[1-216]），65％（95％CI47-90％）的患者实现了5年局部肿瘤无复发生存率。中位PFS为36个月（95%CI24-NA），5年OS估计值为79%（95%CI62-100%）。两名患者在第二个硬膜外部位复发。
结论：肿瘤硬膜外压迫的FL达到所有FL患者的1.6％。基于免疫化疗和放疗的管理似乎产生了与一般FL人群相当的结果。
