결막의 점막연관 림프조직 림프종에서 냉동요법의 장기 결과
Long-Term Outcomes after Cryotherapy for Conjunctival Mucosa-Associated Lymphoid Tissue Lymphomas
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목적: 결막의 점막연관 림프조직 림프종(Mucosa-associated lymphoid tissue lymphoma, MALT lymphoma)에서 냉동요법 후 장기간경과관찰한 결과에 대해 보고하고자 한다. 대상과 방법: 2006년 1월부터 2010년 12월까지 결막에 국한된 MALT 림프종으로 진단 받고 냉동요법을 받은 후 최소한 1년 이상 경과관찰하였던 8명 11안의 의무기록을 후향적으로 분석하였다. 결과: 평균 연령은 36.8세였으며, 평균 경과관찰 기간은 4.1년이었다. 한 차례의 냉동요법을 받은 후 3명 4안은 완치되었고 5명 7안은재발되었다. 2명 2안은 두 차례의 냉동요법을 추가적으로 받은 후 완치되었고, 3명 5안은 두 차례의 냉동요법을 추가적으로 받은후에도 재발되어 방사선치료를 받고 완치되었다. 냉동요법 후 큰 합병증은 없었으며, 4명 6안에서 경미한 결막붙음증만 관찰되었다. 결론: 냉동요법은 방사선치료에 비해 재발률은 높지만 비교적 간단히 시행할 수 있고 합병증이 거의 없는 치료 방법으로 결막에만국한된 MALT 림프종 환자에서 방사선치료를 시행하지 못하는 경우에 대신할 수 있는 치료법으로 고려해 볼 수 있겠다.
Abstract
Purpose: To evaluate long-term outcomes after cryotherapy for conjunctival mucosa-associated lymphoid tissue (MALT) lymphomas. Methods: We retrospectively analyzed 11 eyes of 8 patients who underwent cryotherapy with a confirmed histopathological diagnosis of conjunctival MALT lymphoma between January 2006 and December 2010 and were followed up for at least a year. Results: The mean patient age was 36.8 years and the average follow-up was 4.1 years. Complete remission was achieved in 3 patients (4 eyes) and recurrence occurred in 5 patients (7 eyes) after the first cryotherapy. After the third cryotherapy, complete remission was achieved in 2 patients (2 eyes) and recurrence occurred in 3 patients (5 eyes). Therefore, 3 patients (5 eyes) underwent radiotherapy and finally achieved complete remission. After cryotherapy, significant complications were not observed except mild symblepharon in 4 patients (6 eyes). Conclusions: Cryotherapy, although having a higher recurrence rate than radiotherapy, is a simple treatment modality with fewer complications for patients. In the conjunctival MALT lymphoma patients who cannot undergo radiotherapy, cryotherapy should be considered as an alternative treatment modality.
참고문헌 (26)
- Freeman C., "Occurrence and prognosis of extranodal lymphomas", Cancer, 29, pp.252~260 (1972)
- 이윤선, "안 부속기 림프구증식성 질환의 예후", 대한안과학회지, 44(6), pp.4~1267 (2003), 대한안과학회
- Shields CL., "Conjunctival lymphoid tumors : clinical analysis of 117 cases and relationship to systemic lymphoma", Ophthalmology, 108, pp.979~984 (2001)
- Cho EY., "Clinicopathologic analysis of ocular adnexal lymphomas : extranodal marginal zone b-cell lymphoma constitutes the vast majority of ocular lymphomas among Koreans and affects younger patients", Am J Hematol, 73, pp.87~96 (2003)
- Jakobiec FA., "An overview of ocular adnexal lymphoid tumors", Trans Am Ophthalmol Soc, 87, pp.420~442 (1989)
- Zhou P., "Radiation therapy for orbital lymphoma", Int J Radiat Oncol Biol Phys, 63, pp.866~871 (2005)
- Le QT., "Primary radiotherapy for localized orbital MALT lymphoma", Int J Radiat Oncol Biol Phys, 52, pp.657~663 (2002)
- 지준영, "안와 및 안부속기 악성림프종의 방사선치료", 대한안과학회지, 46(2), pp.3~3 (2005), 대한안과학회
- Isaacson P., "Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma", Cancer, 52, pp.1410~1416 (1983)
- Knowles DM., "Lymphoid hyperplasia and malignant lymphoma occurring in the ocular adnexa(orbit, conjunctiva, and eyelids) : a prospective multiparametric analysis of 108 cases during 1977 to 1987", Hum Pathol, 21, pp.959~973 (1990)
- Johnson TE., "Ocular-adnexal lymphoid tumors : a clinicopathologic and molecular genetic study of 77 patients", Ophthal Plast Reconstr Surg, 15, pp.171~179 (1999)
- Shields CL., "Clinicopathologic reports, case reports, and small case series : rapidly progressive T-cell lymphoma of the conjunctiva", Arch Ophthalmol, 120, pp.508~509 (2002)
- Al-Muammar A., "Conjunctival T-cell lymphoma : a clinicopathologic case report", Ophthalmology, 113, pp.459~461 (2006)
- Dunbar SF., "Conjunctival lymphoma : results and treatment with a single anterior electron field. A lens sparing approach", Int J Radiat Oncol Biol Phys, 19, pp.249~257 (1990)
- Jereb B., "Radiation therapy of conjunctival and orbital lymphoid tumors", Int J Radiat Oncol Biol Phys, 10, pp.1013~1019 (1984)
- Vitu L., "Electron beam irradiation of conjunctival lymphomas", Int J Radiat Oncol Biol Phys, 21, pp.1107~1108 (1991)
- Bhatia S., "Curative radiotherapy for primary orbital lymphoma", Int J Radiat Oncol Biol Phys, 54, pp.818~823 (2002)
- Erickson BA., "Periocular lymphoproliferative diseases : natural history, prognostic factors, and treatment", Radiology, 185, pp.63~70 (1992)
- Xicoy B., "Effectiveness of local radiotherapy in primary extranodal marginal zone B-cell lymphoma of MALT or MALT lymphoma of conjunctiva : study of four cases", Leuk Lymphoma, 43, pp.1975~1977 (2002)
- Stafford SL., "Orbital lymphoma : radiotherapy outcome and complications", Radiother Oncol, 59, pp.139~144 (2001)
- Tsai PS., "Treatment of conjunctival lymphomas", Semin Ophthalmol, 20, pp.239~246 (2005)
- Ellis JH., "Lymphoid tumors of the ocular adnexa. Clinical correlation with the working formulation classification and immunoperoxidase staining of paraffin sections", Ophthalmology, 92, pp.1311~1324 (1985)
- Liao SL., "Results of radiotherapy for orbital and adnexal lymphoma", Orbit, 21, pp.117~123 (2002)
- Martinet S., "Outcome and prognostic factors in orbital lymphoma : a Rare Cancer Network study on 90 consecutive patients treated with radiotherapy", Int J Radiat Oncol Biol Phys, 55, pp.892~898 (2003)
- Eichler MD., "Cryotherapy for conjunctival lymphoid tumors", Am J Ophthalmol, 118, pp.463~467 (1994)
- Tucker SM., "Scleral melt after cryotherapy for conjunctival melanoma", Ophthalmology, 100, pp.574~577 (1993)