The malignant and lymphoid lump be divided into what hero the gold surname lymphoid lump and not the He2 Jie2 Jin's surname lymphoid lump be two kinds of types.At Taiwan, the lymphoid lump of near 90% belongs to not He2 Jie2 Jin's surname lymphoid lump.According to statistic from the Department of Health and not the He2 Jie2 Jin's surname lymphoid lump has in Year 80 of the Republic of China the male cancer die of the ninth.Actually, they were 1 flocks to cover many different pathology organization a type, dissimilarity clinical make progress way, and different cancer disease after prepare, so these lymphoid lump also very hard and same treatment mode and strategy to generalize.
About 20 in the last yearses, provide very quite good curative effect to the lymphoid lump of high and malignant degree in the pathologic ratings because of the chemistry treatment, make to project a treatment of usage circumstance decrease.Clinical up, the treatment which projects a treatment on the lymphoid lump still plays necessary role, for whether lymphoid lump wants to give emanation treatment to depend on several to decide a factor to evaluate or not:(1)Do pathologic and malignant degree ratings and organization type(2) tumor of tumor infringe upon the purpose that the cent of scope expect(3) to cure, cure sex or alleviate sex?Have no instant urgent?(4)Can the position(5) chemotherapy medicine of the tumor effectively cure?In addition projecting a treatment to shine on wild scope and the irradiation amount of has to be also taken into cautious valuation by these factors.Such as in times before lift, because of not pathologic He2 Jie2 Jin's surname lymphoid lump type classification very complicated, although currently new of REAL/WHO classification the method more can respond disease after prepare, because the complexity of its classification may make the hard comprehension of people in general, and majority reference concerning project treatment still with pathologic NCI classification for basis to discuss, so this text is still to take the NCI pathologic classification as main basis, but emanation the treatment is cure lymphoid lump of applied simple cent time four directions to discuss.
1.He2 Jie2 Jin's surname lymphoid lump:
Because tumor invasion scope mostly with body greatly afferent flank lymphoid knot is lord, so have some fixedly put to treat to shine on wild pattern(if the candlestick shine on wild, pour Y to shine on wild etc.), treatment quantity about 30-40 Gies.
Issue 1 and 2:Current treatment method still with project a treatment is lord and have quite good curative effect, decade of livability about 80% go to 90%.
Issue 3 has no B symptom:(fever, the night perspire a lot, the weight ease)Greatly parts of patients cure is a merger to put to treat and chemotherapy, the livability of five years about reaches to 80%.
Issue 3 has B symptom and Issue 4s:The treatment regards chemotherapy as principle, whether should add emanation treatment to consider as an assistance in chemotherapy, the treatment cures boundary to be still carry on studying valuation currently.
2.the NCI pathologic ratings low and malignant degree not He2 Jie2 Jin's surname lymphoid lump:
The lymphoid lump of low and malignant degree is on the whole all quite good to the reaction which projects a treatment, the amount of with 20-35 Gies can attain 95% tumor control a rate, however the most ideal emanation quantity and shine on wild need more valuations.
Issue 1 and 2:Project a treatment in the aspect of this cancer disease already certain have quite good curative effect, the livability of decade about 60% go to 80%.But relapse because of having little parts of tumors in project light upon the outside of the scope, so shine on wild whether should more extensively cover body all lymphoid organizations need a research.
Issue 3:Because the cancer disease infringes upon scope large, some treatment centers use the lymphoid organization of big scope to project a treatment(the irradiation of the total lymphoid), its scope include a the lymphoid knot of neck, the chamber of Zong Ge, and the whole belly cavity, the livability of decade about 30% go to 50%, as for the chemotherapy merger put to treat whether can raise a livability to need a research.
Issue 4:Issue 4 has already delivered to the marrow, feeling, Pi...etc. in person, so many treatment centers try usage whole body irradiation(the irradiation of the total body), but project light upon because of the whole body the emanation amount of can't give too high, make many cancer diseases still keep on carry on.On the other hand, because chemotherapy to the treatment result of the fourth period cancer disease isn't a lymphoid very ideal and greatly part of low and malignant degree either the lump be clinical to make progress very slow-moving, also have theory suggestion to wait until these patient once having symptom, again carry on putting to treat or chemotherapy.
3.the high and malignant degree in the NCI pathologic ratings not He2 Jie2 Jin's surname lymphoid lump:
Medium the lymphoid lump of high and malignant degree bigger to the curative effect difference which projects a treatment, often relate to the size of tumor, if merge chemotherapy, the emanation amount of with 30-35 Gies can attain 80% an above tumor control a rate.The curative effect which uses a chemistry treatment alone for most tumors is alonealso quite good, so regardless is earlier period or later period currently, its treatment method all regards whole body chemotherapy as principle and project a treatment of the use can then be divided into following and a few conditions:
(1)Be used as an assistance in chemotherapy a treatment
If the tumor responds to the chemotherapy very good, cure boundary to project whether treatment needs to still contain a controversy or not to the assistance in chemotherapy currently, although the livability of merger treatment have better tendency, if tumor once relapse, the usage which puts to treat in times before will limit in the days to come again use the strength and number of times of chemotherapy.As for at first bigger tumor whether needs to annex an assistance to project a treatment, and puts to treat should give of quantity, need more researches to confirm it.
(2)Cure the partial emanation of chemotherapy ineffective tumor.
Respond to the chemotherapy bad don't represent to project treatment respond to also must be poor, but in this kind of case, the emanation cure of shine on a wild demand to infringe upon than the tumor of the scope cover more widely, and also often need a higher emanation treatment quantity.
(3)It relapses the partial treatment of tumor after the chemotherapy.
If the chemotherapy of the second line still can't effectively control tumor and generally prepare poor can to the scope of tumor invasion make part to project a treatment according to the patient's condition behind, in order to exaltation survival time or Be the mitigation which improves clinical symptom treatment.
4.lymphoid knot outside lymphoid lump(extranodal lymphoma):
They were also 1 flock to include many different pathology organization a type, different and malignant degree, dissimilarity growth position, and different tumor after prepare, have 20% of lymphoid lump around or so.The position happen in body is known as the majority of the digest way, if the other is located on Waldeyer'the nose of s ring swallow and swallow and saliva gland, paranasal sinus, central nervous system, skin, thyroid gland's etc. may take place.For the sake of convenient discussion project treatment of role, clinical up about be divided into their three ethnicitieses:The first:Using to project treatment majority alone can cure.The most isn't a low and malignant degree He2 Jie2 Jin's surname lymphoid lump.(like MALT lymphoma)
The second:Project the chemistry treatment of the treatment merger contains very high cure rate.Most is medium malignant degree and is a B cell type, often is take place in Waldeyer'the nose of the place of s ring swallow and swallow, paranasal sinus, thyroid gland, breast etc..
The third:Project treatment merger chemistry to cure still don't easily cure cancer disease completely, the one who need to specially study it again to cure a way.Most is medium high and malignant degree and is a T cell type, if deliver sex brain lymphoid lump, the nasal cavity T cell lymphoid lump, the epidermis T cell lymphoid lump etc. at first, clinical top also familiar arrive.
1)deliver sex brain lymphoid lump at first:
Give whole brains the 40-50 Gies plus tumor part of part put strong project light upon a 10-15 Gies, greatly parts of patients all have quite good effect, but most patients also relapse in two years after cure, average survival time no longer than two years, currently many research development the detection merge the chemotherapy can raise survival time.
2)the nasal cavity T cell lymphoid lump:
The good hair is in region in East Asia and the Europe and America are rare.The disease gives in early days tumor the emanation of the 45-50 Gies quantity, five years, the livability can reach to 50-60%, but such as already the distance transfer and then prepare bad behind.
3)the epidermis T cell lymphoid lump:
There is a kind of special disease name call among them the mushroom form fungi disease, the skin performance is very diverse sex and give electronics to the skin pathological changes in earlier period to shoot line of project a treatment, but the later period will spread out lymphatic gland or internal organs and regard chemotherapy as principle.
In addition to above-mentioned discuss it project treatment in the lymphoid lump of applied, at under some urgently special conditions, such as the hard meninges outside lymphoid lump merge spinal nerve oppression, or the lymphoid lump of the chamber of Zong Ge merge up the chamber vein comprehensive disease etc., quickly using to project a treatment can also improve symptom in very short time and avoid the injury that can't reply a dollar.Summary but speech, although chemistry treatment to the height in the pathologic ratings malignant of the lymphoid lump provide very quite good curative effect and plus many low degree the lymphoid lump of the ill nature while diagnose usually tumor infringe upon scope already more wide, but make emanation treatment of the role slightly is treat coldly in recent years.But regardless is make a chemotherapy behind of assistance treatment, or use alone, cure boundary to the role on the treatment which projects treatment in the lymphoid lump, all worthy of re- take in to evaluate.
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