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早期结外鼻型NK/T细胞淋巴瘤疗后远期复发因素分析
陈波,李晔雄,刘清峰,金晶,王维虎,王淑莲,刘跃平,宋永文
100021 北京协和医学院 中国医学科学院肿瘤医院肿瘤研究所放疗科
Analysis of risk factors for late relapse in early-stage extranodal nasal-type NK/T-cell lymphoma after treatment
CHEN Bo, LI Ye-xiong, LIU Qing-feng, JIN Jing, WANG Wei-hu, WANG Shu-lian, LIU Yue-ping, SONG Yong-wen, FANG Hui, REN Hua, ZHAO Ting, WU Run-ye, LIU Xin-fan
Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences,Peking Union Medical College, Beijing100021,China Corresponding author:LI Ye-xiong,
Objective To analyse the late relapse rate of stage ⅠE and ⅡE upper aerodigestive tract natural killer/T-cell lymphoma (UADT-NKTCL) in patients with a disease-free survival (DFS) of at least 5 years after treatment and the risk factors for late relapse. Methods Between January 1983 and October 2007, 114 patients with stage ⅠE and ⅡE UADT-NKTCL received radiotherapy, chemoradiotherapy, or chemotherapy and had a DFS of at least 5 years after treatment. Of the 114 patients, 32 received radiotherapy alone, 80 received chemoradiotherapy, and 2 received chemotherapy alone. The Kaplan-Meier method was used to calculate the relapse rate, and the logrank test was used for survival difference analysis and univariate analysis of risk factors;the Cox regression model was used for multivariate analysis. Results
The follow-up rate was 100%.The number of patients followed-up were 79 at 10 years time. Twelve patients had late relapse (10.5%). 50%(6/12) patients with late relapse developed first locoregional relapse without systemic failure. The 10-year cancer-specific survival and cumulative probabilities of late relapse for entire patients were 92.2% and 8.4%, respectively. In univariate analysis, B symptoms, ECOG≥2,chemotherapy alone and the dose of RT<50 Gy were risk factors to incidence of late relapse (χ2=4.00-11.14,P=0.004-0.045). In multivariate analysis, B symptom was identified as independent correlative factor to incidence of late relapse (HR=4.74(95%CI=1.33-16.93), χ2=5.73,P=0.017). Conclusions Relapse occurs in a small proportion of patients with early-stage UADT-NKTCL who have a DFS of at least 5 years. Systemic symptoms at initial diagnosis is the independent risk factor for late relapse in UADT-NKTCL.
. Analysis of risk factors for late relapse in early-stage extranodal nasal-type NK/T-cell lymphoma after treatment[J]. Chinese Journal of Radiation Oncology, 2013, 22(3): 175-179.
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