Between 1998 and 2009, a total of 295 patients (median age 58, 53% females) with newly diagnosed early-stage follicular lymphoma (FL) were managed at Memorial Sloan Kettering Cancer Center. Approximately half of patients (137, 46%) underwent initial observation and half (158, 54%) immediate treatment: radiation alone (n = 108), systemic treatment alone (n = 29), or combined modality treatment (n = 21). Median follow-up was 8.4 years (range 0.3–17.2), and 10-year overall survival (OS) was 87.2%. OS was similar between initially-observed and immediately-treated patients (hazard ratio [HR]: 1.25, 95% CI: 0.67–2.36, p = 0.49). For patients receiving radiation alone, 5-year OS was 98.0%. Patients selected for systemic therapy alone had high-risk baseline features and had shorter OS than patients treated with radiation alone (HR 3.38, 95% CI 1.29–8.86, p = 0.01). Combined modality treatment did not yield superior survival compared with radiation alone (P > 0.05) but was associated with better progression-free survival (HR 0.36, 95% CI 0.14–0.90, p = 0.03). The rate of transformation increased steadily over time and was 4.2% at 5 years and 10.8% at 10 years. This modern-era analysis rationalized the role of initial observation in patients with early-stage FL although patients receiving radiation therapy also demonstrate excellent outcome.
1998年至2009年间，纪念斯隆-凯特琳癌症中心共收治了295例新诊断的早期滤泡性淋巴瘤患者（中位年龄58岁，53%为女性）。约半数患者（137例，46%）接受初始观察，另一半（158例，54%）接受即刻治疗：其中单纯放疗108例，单纯系统治疗29例，联合治疗21例。中位随访时间为8.4年（范围0.3–17.2年），10年总生存率为87.2%。初始观察组与即刻治疗组的总生存率无显著差异（风险比[HR]：1.25，95%置信区间：0.67–2.36，p=0.49）。接受单纯放疗的患者5年总生存率为98.0%。选择单纯系统治疗的患者具有高风险基线特征，其总生存期短于单纯放疗组（HR 3.38，95% CI 1.29–8.86，p=0.01）。联合治疗与单纯放疗相比未获得更优的总生存率（P>0.05），但具有更好的无进展生存期（HR 0.36，95% CI 0.14–0.90，p=0.03）。转化率随时间持续上升，5年转化率为4.2%，10年转化率达10.8%。这项现代数据分析为早期滤泡性淋巴瘤患者初始观察策略提供了依据，同时接受放射治疗的患者也展现出优异的预后。
肿瘤(癌症)患者之家