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.
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。