MALIGNE NON-HODGKIN-LYMPHOME DES WALDEYERSCHEN RINGS, DER NASENNEBENHOHLEN UND DER SPEICHELDRUSEN. ERGEBNISSE DER STRAHLENTHERAPIE (1951-1976)

Reevaluation and classification according to Rappaport were performed on the histological sections from 63 of 78 adult patients having been treated for malignant non-Hodkin lymphomas (NHL) within the otolaryngological region, between 1951 and 1976. Of the extranodal lymphomas, 84% were localized in the lymphoid ring, two-thirds of them in the tonsil. The site of the tumor did not influence survival rates, and regional predominance of a certain histological type did not appear. 61/63 cases had a diffuse cellular pattern. Diffuse lymphocytic, poorly differentiated, and diffuse histiocytic types were histologically preponderant, each species comprising nearly a third of the cases. Within the diffuse cellular pattern, no differences with regard to the rate of recurrences or of survival as a function of the histological type could be found. In accordance with Ann Arbor staging, 49/63 patients were ranged in the stages IE or IIE. Only 13/49 cases, however, were staged in the manner now approved. In stage IE, of 12 patients 7 (=58%) without staging (CS - clinical staging) obtained 5-year survival free from recurrences, and also 3 (=50%) of the 6 patients with an actual staging (PS = pathological staging). Radiation therapy prior to thorough staging has to be refused for clinical-stage IIE patients, with the exception of a critical situation, since the disease has spread about already in a high percentage of cases; primary radiation therapy is not indicated. Of all the 23 patients with stage IIE (CS), only 2 (=9%) had 4-year survival without recurrences following radiation therapy alone, but of the clearly diagnosed patients, 60% (3/5) obtained 4-year survival without recurrences. In 18% (9/49) of the cases, recurrences in previously irradiated areas occurred during the total course of the disease. In 10% (6/63) of the patients the otolaryngological region and the gastrointestinal track were affected.