Prognostic Factors and Long-term Treatment Outcome in 64 Cases of Early Stage Nasal NK/T- cell Lymphoma
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摘要: 目的:回顾性分析64例早期原发鼻腔NK/T细胞淋巴瘤患者的疗效,探讨其预后因素。方法:收集1993年6月至2005年10月间收治的64例早期原发鼻腔NK/T细胞淋巴瘤患者的资料。根据Ann Arbor分期标准,64例患者均为ⅠE/ⅡE期,单纯放疗23例,其余41例接受放、化联合治疗。单因素分析采用Kaplan-Meier法,多因素分析运用Cox比例风险模型。结果:全组中位生存时间41个月,5年总生存(OS)率为59.17%。单纯放疗组和联合放化疗组5年OS率分别是57.86%和61.45%(P=0.47),二者对生存率影响无明显统计学差异。多因素回归分析表明,治疗前PS评分≥2分、初诊时病灶超腔、首程治疗完全缓解率(CR)低是预后不良的独立因素。结论:对早期鼻腔NK/T细胞淋巴瘤的治疗,放疗加CHOP方案化疗对远期生存率没有提高。治疗前PS评分、初诊时病灶是否超腔、首程治疗完全缓解率,可作为判断鼻腔NK/T细胞淋巴瘤临床预后的参考指标。Abstract: Objective: To retrospectively analyze the long-term treatment outcome of 64 cases of early primary nasal NK/T-cell lymphoma and to explore the prognostic factors. Methods: From July 1993 to October 2005, 64 cases of nasal NK/T-cell lymphoma were diagnosed and confirmed pathologically in our hospital. Data from these patients were retrospectively reviewed. According to the Ann Arbor staging classification, the 64 patients belong to stage ⅠE/ⅡE. Twenty-three patients received radiotherapy alone, and the other 41 cases received chemotherapy combined with radiotherapy. Kaplan-Meier methods were applied in unifactorial analysis, and the Cox regression model was applied in multivariate analysis. Results: The median overall survival time was 41 months, and the 5-year overall survival (OS) rate was 59.17%. Those who received radiotherapy alone had a 5-year OS rate of 57.86% and for those who received radiotherapy combined with chemotherapy the 5-year OS rate was 61.45%. No significant difference was found (P=0.47). Multivariate analysis showed that Eastern Cooperative Oncology Group(ECOG) performance status (PS) score ≥2, local tumor invasion out of the nasal cavity and lower complete response rate to the primary treatment were significant unfavorable independent prognostic factors. Conclusion: Chemotherapy combined with radiotherapy does not improve the survival of patients with early stage nasal NK/T-cell lymphoma. PS score before treatment, local tumor invasion out of the nasal cavity, and complete response rate to the primary treatment are independent prognostic factors.
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Keywords:
- Nasal cavity /
- Non-Hodgkin's Lymphoma /
- NK/T-cell /
- Treatment /
- Prognosis
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