外周T细胞淋巴瘤非特异型58例临床分析

Clinical analysis of 58 cases of peripheral T-cell lymphoma not otherwise specified

目的对外周T细胞淋巴瘤非特异型的临床特征、治疗和预后进行分析,探讨其治疗策略及预后因素。方法回顾性分析1999年1月至2005年12月我院收治的58例外周T细胞淋巴瘤非特异型患者的临床特征、治疗方法和疗效与预后的关系。结果全组男性46例(79.3%);中位年龄42岁;Ⅲ/Ⅳ期27例(46.6%);IPI评分低危37例(63.8%)、低中危7例(12.1%)、高中危12例(20.7%)、高危2例(3.4%);单纯化疗15例(25.9%),化放疗联合治疗43例(74.1%)。化疗有效率76.5%,其中初始化疗CR率29.4%;加入放疗后CR率提高至47.1%。全组患者1,3,5年无病生存率和总生存率分别为41.4%、37.9%、22.4%和69.0%、46.6%、31.0%。多因素分析结果显示,近期疗效(P=0.000)和骨髓受侵(P=0.012)是本组病例的独立预后因素。结论化疗加放疗的综合治疗可提高CR率,改善远期生存。

Objective To investigate the clinical features,therapy and prognosis of patients with peripheral T-cell lymphomas not otherwise specified（PTCL-NOS）.Methods Fifty-eight patients with PTCL-NOS treated from January 1999 to December 2005 in Academy of Medical Sciences and Peking Union Medical College Cancer Hospital were enrolled and analysed retrospectively.Results Forty-six of the patients（79.3%）were males and median age of the patients was 42 years.Stage Ⅲ/Ⅳ were 46.6%.International Prognostic Index（IPI）score low risk cases were 63.8%,low-intermediate risk cases 12.1%,high-intermediate risk cases 20.7% and high risk cases 3.4%.25.9% of the patients were treated with chemotherapy alone while 74.1% with chemotherapy plus involved field radiotherapy.Response rate with chemotherapy alone were 76.5% with 29.4% CR.Addition of radiotherapy raised CR to 47.1%.1-,3-and 5-year disease free survival rates and overal survival rates were 41.4%,37.9%,22.4% and 69.0%,46.6% and 31.0% respectively.Multivariate analysis showed that first treatment response and bone marrow involvement were independent prognostic factors for PTCL-NOS.Conclusions Chemo-radiotherapy can raise CR rates and improve long-time survival.