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诱导化疗联合放疗在早期结外NK/T细胞淋巴瘤的预后分析
吴涛, 李环, 刘秋琳, 张婧, 胡云飞, 陈梦翔, 黄韵红
贵州医科大学附属医院,贵州医科大学附属肿瘤医院肿瘤科,贵阳 550001
Prognostic analysis of early stage extranodal natural-killer/T cell lymphoma treated with induced chemotherapy combined with radiotherapy
Wu Tao, Li Huan, Liu Qiulin, Zhang Jing, Hu Yunfei, Chen Mengxiang, Huang Yunhong
Department of Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550001, China
Abstract：Objective To analyze the efficacy and prognostic factors of induced chemotherapy combined with radiotherapy in the treatment of early stage extranodal natural-killer/T cell lymphoma (ENKTCL). Methods Two hundred and eighty-seven early stage NKTCL patients were treated in Affiliated Cancer Hospital of Guizhou Medical University from October 2003 to October 2021. All patients were aDministrated with short courses of induced chemotherapy combined with radiotherapy. Clinical prognostic factors of early stage NKTCL were analyzed. The overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan-Meier method, log-rank test was conducted for univariate analysis and Cox models were performed for multivariate analysis. Results The 5-year OS and PFS were 72.8% and 68.9% in all patients. According to Nomogram risk index (NRI) prognostic model, 286 patients were divided into the low risk (NRI=0), intermediate low risk (NRI=1), intermediate high risk (NRI=2), high risk (NRI=3) and very high risk (NRI≥4) groups. In these 5 groups, the 5-year OS were 95.6%,76.3%,69.5%,61.0% and 23.3%(all P<0.001), and the 5-year PFS were 93,2%, 69.8%, 64.6%, 60.2% and 23.3%(all P<0.001), respectively. In the radiotherapy with a dose of ≥50Gy and<50Gy groups, the 5-year OS were 73.8% and 65.9%(P=0.123) and the 5-year PFS were 72.8% and 45.3%(P=0.001). According to the response to induced chemotherapy of complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD), the 5-year OS were 85.4%,74.0%,61.8% and 28.5%(all P<0.001), and the 5-year PFS were 83.7%,66.8%,65.7% and 27.4%(all P<0.001), respectively. Univariate analyses showed that stage Ⅱ, ECOG≥2, primary tumor invasion, radiotherapy dose<50Gy and short-term efficacy of induced chemotherapy were poor prognostic factors for the 5-year OS and PFS (all P<0.05). Multivariate analyses demonstrated that primary tumor invasion, ECOG≥2 and stage Ⅱ were poor prognostic factors for OS (all P<0.05), and primary tumor invasion and ECOG≥2 were poor prognostic factors for PFS (all P<0.05). Conclusions Early stage NKTCL patients can obtain high efficacy after induced chemotherapy combined with radiotherapy.complete response to induced chemotherapy is associated with favorable prognosis.
Wu Tao,Li Huan,Liu Qiulin et al. Prognostic analysis of early stage extranodal natural-killer/T cell lymphoma treated with induced chemotherapy combined with radiotherapy[J]. Chinese Journal of Radiation Oncology, 2021, 30(12): 1250-1255.
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