38例早期鼻腔NK/T细胞淋巴瘤治疗的临床研究

Clinical review on the treatment of 38 cases with early extranodal natural killer/T cell lymphoma,nasal type

目的探讨Ⅰ、Ⅱ期鼻腔NK/T细胞淋巴瘤临床特征、治疗及预后情况。方法回顾性分析经病理及免疫组化证实的38例鼻腔NK/T细胞淋巴瘤患者的临床资料,均为Ann-Arbor分期的IE、IIE期,其中14例行单纯放疗,24例行放化综合治疗,分析临床特征、治疗及预后情况。结果 5年生存率为68.4%,单纯放疗、放化综合治疗患者的5生存率分别为63.3%、70.8%。Log-rank分析结果示,影响鼻腔NK/T淋巴瘤患者生存的因素:年龄、B症状、LDH值和初次疗效(P<0.05)。结论Ⅰ、Ⅱ期鼻腔NK/T细胞淋巴瘤患者,年龄>60岁、有B症状、LDH值升高以及初治疗效未达到完全缓解提示预后较差;与单纯放疗比较,放化疗并不显著提高5年生存率。

Objective To understand clinical characteristics, therapy and prognosis of patients with stage Ⅰ-Ⅱ extranodal natural killer/T cell lymphoma, nasal type （E）NKTL. Method The clinical data of 38 cases with stage Ⅰ-Ⅱ ENKTL confirmed by H＆E and i mmunohistoehemieal was firstly analyzed by retrospective analysis. 14 cases were treated with radiotherapy alone and the other 24 cases were treated with radiotherapy and chemotherapy. The clinical characteristics, therapy and prognosis of the subjects were analyzed. Findings The five-year survival rate was 68.4%. The survival rates of the group treated with radiotherapy alone and the group treated with radiotherapy and chemotherapy were 63.3% and 70. 8% respectively. Log-rank analysis showed that age, B symptoms, state of lymph node, mode of treatment and first effect were the prognostic factors. Conclusion Stage Ⅰ-Ⅱ ENKTL patients who are more than 60 years old, with B symptoms, nodal involvement or not achieving CR in initial treatment are given poor prognosis. Radiotherapy and chemotherapy does not guarantee higher five-year survival rate than radiotherapy.