111例T细胞非霍奇金淋巴瘤的临床预后分析

Survival Outcomes of T-cell Non-Hodgkin's Lymphoma: a Report of 111 Cases

背景与目的:T细胞非霍奇金淋巴瘤(non鄄Hodgkin蒺slymphoma,NHL)是一组异质性淋巴系统恶性疾病,我国较西方国家多见,预后不良,目前尚无理想的治疗方案。本研究回顾性分析111例T细胞淋巴瘤的临床特征与预后的关系。方法:选取1994年1月～2001年12月中山大学肿瘤防治中心收治有完整临床资料的T细胞NHL111例,所有的病例按WHO2001分类标准进行病理分型,并对其临床资料进行分析,总结其与预后的关系。结果:111例患者的中位年龄是37岁(7～77岁),82例患者为男性,女性29例,中位生存期28个月,3年总生存率为45%。45例(40.5%)患者采用化、放联合的治疗方式,62例(55.8%)患者采用单纯化疗,4例(3.6%)患者采用单纯放疗;化放联合治疗组、单纯化疗组和单纯放疗组患者的3年生存率分别为56%、38%和25%。所有病理亚型中NK/T细胞淋巴瘤预后最差,3年总生存率只有25%;非特殊性外周T细胞淋巴瘤(PTCL鄄U)次之,3年总生存率在40%左右;而间变性大细胞性淋巴瘤(ALCL)的3年总生存率接近85%。Ⅰ+Ⅱ期患者较Ⅲ+Ⅳ期患者有更好的生存期,淋巴瘤国际预后指征是预测生存期的一个重要因素,低危组、低中危组、中高危组以及高危组的3年生存率分别为60%、30%、10%和0%。结论:对于T细胞来源的淋巴瘤尤其是分期较晚和IPI评分高危的患者,目前的治疗方?

BACKGROUND & OBJECTIVE: T-cell non-Hodgkin's lymphoma (NHL) is a gro up of heterogeneous malignancies with poor prognosis, and without ideal therapeu tic regimen. This study was to summarize clinical and pathologic features of T-c ell NHL. METHODS: Records of 111 patients with T-cell NHL, treated from Jan. 199 4 to Dec. 2001 in Cancer Center of Sun Yat-sen University, were retrospectively analyzed. All the patients were classified according to WHO classification crite ria. RESULTS: Median age of the whole group was 37 years (ranged 7-77 years). Of the 111 patients, 82 were men, 29 were women; 45 (40.5%) were treated with chem oradiotherapy, 62 (55.8%) were treated with chemotherapy alone, and 4 (3.6%) wer e treated with radiotherapy alone. The 3-year survival rate of the whole group w as 45% with a median follow-up of 28 months. The 3-year survival rates of chemor adiotherapy, chemotherapy, and radiotherapy groups were 56%, 38%, and 25%, respe ctively. Among all histological type subgroups, the prognosis of NK/T-cell lymph oma was the worst with the 3-year survival rate of only 25%; the 3-year survival rate was 40% in unspecified peripheral T-cell lymphoma group,and 85% in angioim munoblast T-cell lymphoma group. International prognostic index was a significan t factor for predicting overall survival. The 3-year survival rates of low risk, low-intermediate risk,intermediate-high risk, and high risk groups were 60%, 30% , 10%, and 0%, respectively. CONCLUSIONS: Present treatment modalities for T-cel l NHL patients, especially the high risk patients, can't achieve satisfactory ou tcomes. New treatment modality for these patients needs to be explored.