【摘要】 目的分析鼻腔 NK/T 细胞淋巴瘤放疗和化疗的近期疗效,不同的治疗方法对生存率的影响及影响预后的因素。方法 1996年1月至2002年12月共收治116例经病理形态学诊断为鼻腔 NK/T 细胞淋巴瘤的患者。其中50例经免疫组化证实。根据 Ann Arbor 分期,Ⅰ期95例,Ⅱ期21例。单纯放疗22例;单纯化疗6例;其余88例采用综合治疗,其中41例先放疗后化疗,47例先化疗后放疗。结果全组5年总生存(OS)率和无病让存(DFS)率分别是74.1%和61.5%。Ⅰ期和Ⅱ期患者的5年 OS 率分别是75.1%和68.0%(P=0.45),DFS 率分别是64.7%和47.8%(P=0.07)。首程治疗后达 CR 患者的5年 OS 率为86.5%,而未达 CR 患者的5年 OS 率为18.4%(P=0.000),相应5年 DFS 率分别为71.5%和17.2%(P=0.000)。63例患者接受单纯放疗或放疗后化疗,放疗后完全缓解(CR)率为74.6%。其余53例为化疗后放疗或单纯化疗,化疗后 CR 率仅20.8%(P=0.000)。全组患者中先放疗组(放疗加或不加化疗)、化疗后放疗组的5年 OS 率分别为76.8%和78.8%,DFS率分别为65.4%和61.8%(P>0.05)。多因素回归分析显示,仅首程治疗后的 CR 率是独立的预后因素。结论早期鼻腔 NK/T 细胞淋巴瘤放疗的近期疗效显著优于常规化疗,化疗加入放疗并未改善生存率。早期患者应以放射治疗为主要治疗手段。更多还原

【Abstract】 Objective To analyze initial response rate of radiotherapy and chemotherapy for early na- sal NK/T-cell lymphoma,and its prognostic factors.Methods From January 1996 to December 2002,116 patients with nasal NK/T-cell lymphoma were diagnosed pathologically,Immunophenotyping was performed in 50 cases.According to Ann Arbor staging classification,95 patients were stage Ⅰ_E and 21 Ⅱ_E.Of the 116 patients,22 received radiotherapy alone,6 chemotherapy alone and 88 combined modality therapy (CMT), including,41 radiotherapy followed by chemotherapy,and 47 chemotherapy followed by radiotherapy.Results The 5-year overall survival (OS) rate and disease free survival (DFS) rate for all patients was 74.1% and 61.5%,respectively.For stage Ⅰ_E and Ⅱ_E patients,the 5-year OS rate was 75.1% and 68% (P=0.45), and DES rate was 64.7% and 47.8%,respectively (P=0.07).The 5 year OS rate and DFS rate were 86.5% and 71.5% for patients who achieved complete response (CR),and 18.4% and 17.2% for those who didn’t,respectively (P=0.000).Sixty-three patients were treated with radiotherapy alone or radiother- apy followed by chemotherapy,while 53 with chemotherapy followed by radiotherapy or chemotherapy alone. The CR rate for radiotherapy was 74.6% while for chemotherapy was 20.8% (P=0.000).The 5-year OS rate and DFS rate were 76.8% and 65.4% for radiotherapy with or without chemotherapy,and 78.8% and 61.8% for chemotherapy followed by radiotherapy (P>0.05).Multivariate analysis by COX regression showed that CR rate was the only independent prognostic factor.Conclusion The CR rate of radiotherapy is much higher than that of conventional chemotherapy.Addition of chemotherapy to radiotherapy do not improve the survival of patients with early stage nasal NK/T-cell lymphoma.Radiotherapy is the primiary treatment for stage Ⅰ and Ⅱ nasal NK/T-cell lymphoma.更多还原