130例鼻腔和韦氏环NK/T细胞淋巴瘤放化疗预后分析

doi:10.3760/cma.j.issn.1004-4221.2013.03.002

摘要
图/表
参考文献()
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (0 KB) HTML (0 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要

目的观察鼻腔、韦氏环NK/T细胞淋巴瘤放化疗疗效,并分析影响预后的因素。
方法2000—2010年本院共收治经免疫组化确诊130例鼻腔、韦氏环NK/T细胞淋巴瘤,其中鼻腔的109例、韦氏环的21例。Ann Arbor分期Ⅰ_E期116例、Ⅱ_E期14例。单纯放疗30例,单纯化疗2例,放化疗联合98例。
结果随访率100%,随访时间满5年者78例。完全缓解率全组为89.2%,Ⅰ_E、Ⅱ_E期的分别为88.8%、92.9%(χ²=0.02,P=0.837),单纯放疗、放化疗联合的分别为86%、96%(χ²=1.44,P=0.230)。全组5年总生存(OS)和无瘤生存(DFS)率分别为58.0%和57.2%,Ⅰ_E、Ⅱ_E期患者5年OS分别为60.6%、36.3%(χ²=0.25,P=0.615),5年DFS分别为59.7%、36.3%(χ²=0.21,P=0.648);单纯放疗、放化联合的5年OS分别为70%、48%(χ²=0.01,P=0.933),5年DFS分别为66%和48%(χ²=0.09,P=0.764)。单纯放疗、放化联合的主要3、4级不良反应总发生率分别为6.7%、54.1%(χ²=41.38,P=0.002)。原发灶照射剂量(χ²=3.18,P=0.005)、ECOG评分(χ²=2.97,P=0.008)与OS相关。
结论 Ⅰ_E、Ⅱ_E期鼻腔、韦氏环NK/T细胞淋巴瘤放化联合与单纯放疗疗效相似,但不良反应较重;原发灶照射剂量、ECOG评分是影响OS的因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	罗加林
	刘鲁迎
	吴润叶
	朱远

关键词 ：鼻腔淋巴瘤/放化疗法, 韦氏环淋巴瘤/放化疗法, 淋巴瘤, NK/T细胞, 预后

Abstract：

Objective To observe the clinical effects of radiotherapy and/or chemotherapy in the treatment of nasal and Waldeyer ring natural killer (NK)/T cell lymphoma and to analyze the prognostic factors. Methods Between January 20, 2000 and December 21, 2010, 109 patients with nasal NK/T cell lymphoma and 21 patients with Waldeyer ring NK/T cell lymphoma were admitted to our hospital;the diagnosis was confirmed by immunohistochemistry. According to the Ann Arbor staging system, 116 patients were classified as stage Ⅰ_E, and 14 as stage Ⅱ_E. Thirty patients received radiotherapy alone;2 patients received chemotherapy alone;98 patients received radiochemotherapy. Results The follow-up rate was 100%. Seventy-eight patients were followed up for at least 5 years. The complete remission (CR) rate was 89.2% in all patients. The CR rates of stage Ⅰ_E patients and stage Ⅱ_E patients were 88.8% and 92.9%, respectively (χ²=0.02, P=0.837). The CR rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 86% and 96%, respectively (χ²=1.44, P=0.230). The five-year overall survival (OS) rate and disease-free survival (DFS) rate of all patients were 58.0% and 57.2%, respectively. The five-year OS rates of stage Ⅰ_E patients and stage Ⅱ_E patients were 60.6% and 36.3%, respectively (χ²=0.25, P=0.615);the five-year DFS rates of stage Ⅰ_E patients and stage Ⅱ_E patients were 59.7% and 36.3%, respectively (χ²=0.21, P=0.648). The five-year OS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 70.0% and 48.4%, respectively (χ²=0.01, P=0.933);the five-year DFS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 65.6% and 48.4%, respectively (χ²=0.09, P=0.764). The grade 3—4 toxicity rates of radiotherapy alone and radiochemotherapy were 6.7% and 54.1%, respectively (χ²=41.38, P=0.002). The radiation dose to the primary lesion and Eastern Cooperative Oncology Group(ECOG) score were correlated with OS (χ²=3.18, P=0.005;χ²=2.97, P=0.008). Conclusions
The clinical effect of radiochemotherapy is similar to that of radiotherapy alone in the patients with stage Ⅰ_E

Key words： Nasal cavity lymphoma/radiochemotherapy Waldeyer ring lymphoma/radiochemotherapy Lymphoma, natural killer/T cell Prognosis

收稿日期: 2012-12-10

基金资助:

江苏省“十二五”临床医学重点学科资助(2011-12)

引用本文:

罗加林,刘鲁迎,吴润叶等. 130例鼻腔和韦氏环NK/T细胞淋巴瘤放化疗预后分析[J]. 中华放射肿瘤学杂志, 2013, 22(3): 180-183.

LUO Jia-lin,LIU Lu-ying,WU Run-ye et al. Prognostic analysis of 130 patients with nasal and Waldeyer ring NK/T cell lymphoma treated by radiotherapy and/or chemotherapy[J]. Chinese Journal of Radiation Oncology, 2013, 22(3): 180-183.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2013.03.002 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2013/V22/I3/180

[1] 金晶,李晔雄,姚波,等.Ⅰ_E-Ⅱ_E期鼻腔NK/T细胞淋巴瘤的放疗.中华放射肿瘤学杂志,2006,15:108-113.

[2] You JY, Chi KH, Yang MH, et al. Radiation therapy versus chemotherapy as initial treatment for localized nasal natural killer (NK)/T-cell lymphoma:a single institute survey in Taiwan. Ann Oncol,2004,15:618-625.

[3] Cheung MM, Chan JK, Lau WH, Early stage nasal NK/T-cell lymphoma:clinical outcome, prognostic factors, and the effect of treatment modality. Int J Radiat Oncol Biol Phys,2002,54:182-190.

[4] Kim K, Chie EK, Kim CW, et al. Treatment outcome of angiocentric T-cell and NK/T-cell lymphoma, nasal type:radiotherapy versus chemoradiotherapy. Jpn J Clin Oncol,2005,35:1-5.

[5] Kim BS, Kim TY, Kim CW, et al. Therapeutic outcome of extranodal NK/T-cell lymphoma initially treated with chemotherapy—result of chemotherapy in NK/T-cell lymphoma. Acta Oncol,2003,42:779-783.

[6] Li YX, Liu QF, Fang H, et al. Variable clinical presentations of nasal and Waldeyer ring natural killer/T-cell lymphoma. Clin Cancer Res,2009,15:2905-2912.

[7] Jaffe ES, Chan JK, Su IJ, et al. Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphomas. Definitions, differential diagnosis, and epidemiology. Am J Surg Pathol,1996,20:103-111.

[8] Barrionuevo C, Zaharia M, Martinez MT, et al. Extranodal NK/T-cell lymphoma, nasal type:study of clinicopathologic and prognosis factors in a series of 78 cases from Peru. Appl Immunohistochem Mol Morphol,2007,15:38-44.

[9] Faith CSH, Todd D, Loke SL, et al. Clinico-pathological features of malignant lymphoma in 294 Hong Kong Chinese patients retrospective study covering an eigh-t year period. Int J Cancer,1984,34:143-148.

[10] 李晔雄,顾大中,黄一容,等.Ⅰ、Ⅱ期鼻腔非霍奇金氏淋巴瘤的预后与治疗.中华放射肿瘤学杂志,1994,3:97-100.

[11] Peh SC, Quen QW. Nasal and nasal type natural killer (NK)/T cell lymphoma immunophenotype and Epstein-Barr virus (EBV) association. Med J Malaysia,2003,58:196-204.

[12] Kim GE, Lee SW, Chang SK, et al. Combined chemotherapy and radiation versus radiation alone in the management of localized angiocentric lymphoma of the head and neck. Radiother Oncol,2001,61:261-269.

[13] Kim K, Chie EK, Kim CW, et al. Treatment outcome of angiocentric T-cell and NK/T-cell lymphoma, nasal type:radiotherapy versus chemoradiotherapy. Jpn J Clin Oncol,2005,35:1-5.

[14] Kim GE, Cho JH, Yang WI,et al. Angiocentric lymphoma of the head and neck:patterns of systemic failure after radiation treatment. J Clin Oncol,2000,18:54-63.

[15] Li YX, Yao B, Jin J, et al. Radiotherapy as primary treatment for stage Ⅰ_E and Ⅱ_E nasal natural killer/T-cell lymphoma. J Clin Oncol,2006,24:181-189.

[16] Li YX, Fang H, Liu QF, et al. Clinical features and treatment outcome of nasal-type NK/T-cell lymphoma of Waldeyer ring. Blood,2008,112:3057-3064.

[17] Isobe K, Uno T, Tamaru J,et al. Extranodal natural killer/T-cell lymphoma, nasal type:the significance of radiotherapeutic parameters. Cancer,2006,106:609-615.

[18] Wu X, Li P, Zhao J, et al. A clinical study of 115 patients with extranodal natural killer/T-cell lymphoma, nasal type. Clin Oncol (R Coll Radiol）,2008,20:619-625.

[19] Li CC, Tien H F, Yao M, et al. Treatm ent outcome and pattern of failure in 77 patients with sinonasal natural killer/T-cell or T-cell lymphoma. Cancer,2004,100:366-375.

[20] Wang H, Li YX, Wang WH, et al. Mild toxicity and favorable prognosis of high-dose and extended involved-field intensity-modulated radiotherapy for patients with early-stage nasal NK/T-cell lymphoma. Int J Radiat Oncol Biol Phys,2012,82:1115-1121.