鼻腔NK/T细胞淋巴瘤60例临床治疗和预后分析

The Clinical Treament and Prognostic Factors of 60 Nasal NK/T Cell Lymphoma Patients

目的探讨鼻腔NK/T细胞淋巴瘤不同的临床特征、近期疗效及治疗模式对远期生存及预后的影响。方法收集江西省肿瘤医院1995年1月至2005年12月共60例鼻腔NK/T细胞淋巴瘤患者临床资料。应用多因素分析对其临床特征、近期疗效及治疗模式进行相关性分析。结果全组患者5年总生存(OS)率和无病生存(DFS)率分别为67.56%和43.29%。全组患者中,22例首先接受放疗,完全缓解(CR)率为68.18%;38例首先接受化疗,CR率为15.79%。治疗完成后CR与非CR患者的5年OS率及DFS率分别为82.6%对47.84%(P=0.005);58.31%对22.57%(P=0.003)。综合治疗中,首先接受化疗或者放疗两组间5年OS率及DFS率均无统计学意义。放、化疗结合的综合治疗相比单纯放疗或化疗而言,明显提高了远期生存(P<0.05)。COX多因素回归分析显示,治疗模式与KPS评分是独立的预后因素。结论鼻腔NK/T细胞淋巴瘤放疗的近期疗效明显优于化疗。改善一般状况、采用综合治疗模式及治疗后达到CR能明显提高患者远期生存。鼻腔NK/T细胞淋巴瘤患者应接受以放疗或放疗为主的综合治疗。

Objective To analyze long-survival rate of different clinical characteristics initial response and treatment mode for nasal NK/T cell lymphoma, and its prognostic factors. Methods From January 1995 to December 2005,60 patients with nasal NK/T cell lymphoma of jiangxi oncology hospital were collected. To analyze long survival rate of different clinical characteristics initial response and treatment mode for nasal NK/T cell lymphoma. Results The 5-year overall survival（OS） rate and disease free survival（DFS） rate for all patients were 67.56% and 43.29%. Twenty-two patients were treated with radiotherary frist, the complete response rate（CR） for radiotherary was 68.18% , while thirty-eigth patients with chemotherary frist, while for chemotherary was 15.79%. The 5-year OS rate and DFS rate for CR and no-CR patients were 82.6% VS 47.87% （P = 0.005 ） 58.31% VS 22,57% （P = 0. 003 ） respectively. Thirteen patients were treated with radiotherary followed by chemotherary,while twenty-one patients with chemotherary, The 5-year OS rate and DFS rate along their without any significant difference. Integration treatment can enhance lone-survival compare with chemotherary or radiotherary alone （ P 〈 0. 05 ）. Multivariate analysis by COX regression showed that treatment mode and KPS grade were independent prognostic factors. Conclusion The initial response of radiotherary is much higher than ehemotherary. Improve general status,syndrome and CR can enhance long-survival. Radiotherary or basic radiotherary is the primary treatment for nasal NK/T cell lymphoma.