摘要
目的探讨早期结外鼻型NK/T细胞淋巴瘤(ENKTL)接受GELOX(吉西他滨、奥沙利铂、左旋门冬酰胺酶)方案化疗和放疗疗效及影响因素。方法回顾分析2007--2013年间收治的74例ⅠE-ⅡE期ENKTL患者,根据化疗方案及有无放疗分为3个组,A组47例为首选GELOX化疗后根治性放疗,B组10例为其他方案化疗改用GELOX挽救后放疗,C组17例为接受GELOX方案化疗后未放疗。全组化疗中位3周期,放疗中位剂量54.6Gy分20-30次。结果全组化疗后CR率33.8%(其中放疗后为90%),2年OS和PFS分别为88%和79%。A+C组的疗后CR率、2年0s和PFS分别为73%、92%和84%。A组的2年0S和PFS(96%和84%)均高于B组(50%和45%)和C组(47%和40%,P均〈0.05)。单因素分析显示疗前LDH水平升高和化疗后无缓解是OS和PFS的不良预后因素,局部广泛侵犯也是OS的不良预后因素;多因素分析显示化疗后无缓解是OS及PFS的不良预后因素。结论早期ENKTL患者接受GELOX诱导化疗结合根治性放疗可获得良好疗效.但该方案用于单纯化疗和挽救化疗的疗效仍不理想。
Objective To investigate the treatment outcome and prognostic factors in patients with early-stage extranodal nasal-type natural killer/T-cell lymphoma (ENKTL) who underwent chemotherapy with GELOX ( gemcitabine, oxaliplatin, and L-asparaginase) regimen combined with radiotherapy. Methods The clinical data of 74 patients with stage IE-IIE ENKTL who were admitted from 2007 to 2013 were analyzed retrospectively, and based on the chemoradiotherapy regimen and whether they underwent radiotherapy, these patients were divided into three groups. The 47 patients in group A received the preferred chemotherapy with GELOX regimen and then radical radiotherapy;the 10 patients in group B received another regimen at first, then received GELOX as the rescue chemotherapy, and underwent radiotherapy; the 17 patients in group C underwent the chemotherapy with GELOX regimen and did not receive radiotherapy. The median number of cycles of chemotherapy was 3, and the median dose of radiotherapy was 54. 6 Gy in 20-30 fractions. Results The complete response (CR) rate after chemotherapy was 34% and the CR rate after radiotherapy was 90%.The 2-year overall survival ( OS ) and progression-free survival ( PFS ) rates were 88% and 79%, respectively. The CR rate and 2-year OS and PFS rates for group A + C were 73%, 92%, and 84%, respectively. Group A had significantly higher OS and PFS than group B and group C (96%/84% vs. 50%/ 45% and 47%/40% ;all P〈0. 05).The univariate analysis showed that elevated lactate dehydrogenase level and no response after chemotherapy were the adverse prognostic factors for OS and PFS, and extensive local invasion was the adverse prognostic factor for OS. The multivariate prognostic analysis indicated that no response after chemotherapy was the adverse prognostic factor for OS and PFS. Conclusions The patients with early-stage ENKTL can achieve a good outcome after induction chemotherapy with GELOX regimen combined with radical radiotherapy, but this regimen has no ideal efficacy when applied alone or as rescue chemotherapy.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2016年第2期140-145,共6页
Chinese Journal of Radiation Oncology