不同治疗方案对原发于鼻咽部非霍奇金淋巴瘤疗效分析

Analysis of different treatment of non-Hodgkin's lymphoma of the nasophyrynx

目的探讨以鼻咽部为首发部位的非霍奇金淋巴瘤的临床特征、治疗方法和预后。方法回顾性分析北京协和医院1994～2007年12月期间收治的66例首发于鼻咽部非霍奇金淋巴瘤患者,比较其临床特点,探讨其治疗方式及预后。结果首发于鼻咽部的淋巴瘤66例,男40例,女26例,81%首发于鼻腔或鼻窦,以鼻塞、流涕为主要临床表现,主要治疗分单放疗、单化疗、先放后化、先化后放4种,有效率分别为100%(3/3)、40%、60%、87%,生存期分别为43个月、8个月、10个月、42个月(P>0.05)。病理类型、国际预后指数、分期可能对患者的生存产生影响。结论首发于鼻咽部非霍奇金淋巴瘤在临床表现上有特殊的表现,治疗应以综合治疗为主。对T细胞和NK/T细胞来源、分期晚、局部侵犯或中高危患者应采取更加积极的治疗手段。

Objective To define the natural history, clinicopathological findings, prognostic factors, and treatment outcome of patients with non-Hodgkin＇s lymphoma （NHL） of the nasal cavity and nasopharynx. Methods The clinicd data of 66 patients with NHL who were followed up in our hospital from 1994 to 1997 were retrospectively reviewed. Result Totally 66 （26 women and 40 men） patients with nasal cavity and nasopharyngeal, 81% occured in nasal cavity or nasopharynx. The most common presentation was nasal obstruction and nasal discharge. The vast majority of patients were managed with a sequential combination of chemotherapy and radiation therapy, which was better than radilotherapy or chemotherapy alone. For radiation, chemotherapy, radiation followed by chemotherapy, and chemotherapy followed radiation, the overall response rates were 100% （3/3）, 40%, 60%, and 87%, respectively, and the overall survival was 43 months, 8 months, 10 months, and 42 months, respectively （P 〉0. 05）. Pathologic type, International Prognosis Index （IPI） and stage might affect the survival of patients. Conclusions The nasal cavity and nasopharyngeal non -Hodgkin＇s lymphoma is an uncommon disease with special clinical presentation. Combined modality therapy is superior to other treatment options. For patients with T or NK/T pathological type, advanced stage, local infiltrating disease or high IPI, more active treatment tragedy should be adopted .