初治Ⅰ/ⅡE期原发上呼吸消化道结外NK/T细胞淋巴瘤临床特征及治疗疗效的分析

Clinical features and therapeutic effect in primary stageⅠ/ⅡE upper aerodigestive tract extranodal NK/T cell lymphoma

目的探讨初治Ⅰ/ⅡE期原发上呼吸消化道结外NK/T细胞淋巴瘤(upper aerodigestive tract extranodal natural kill T-cell lymphoma,UAT-ENKTCL)患者的临床特征和疗效。方法回顾性分析2009年6月—2020年6月解放军总医院收治初治Ⅰ/ⅡE期UAT-EN KTCL患者的临床不同治疗模式与首程疗效的关系。结果纳入61例UAT-EN KTCL患者,依据治疗模式分为单纯化疗和序贯化放疗2组,首程疗效达完全缓解(complete response,CR)率分别为62.5%、82.2%(χ^(2)=1.714,P=0.190)。全组患者化疗方案分别采用蒽环类组、蒽环类联合门冬酰胺酶类组及非蒽环类联合门冬酰胺酶类组,相应CR率分别为46.7%、72.7%、91.7%(χ^(2)=91.155,P<0.001);5年总生存率分别为46.7%、68.2%、94.4%(χ^(2)=9.893,P=0.007),5年无进展生存率分别为33.3%、63.6%、79.7%(χ^(2)=8.575,P=0.014),非蒽环类+门冬酰胺酶组的疗效优于其余2组,差异均具有统计学意义(P=0.007、0.005、0.002、0.004)。结论初治Ⅰ/ⅡE期UAT-ENKTCL采用以非蒽环类联合门冬酰胺酶为主的化疗方案明显提高患者治疗疗效。

Objective To investigate the clinical features of and curative effect against upper aerodigestive tract extranodal natural kill T-cell lymphoma(UAT-ENKTCL).Methods The clinical data of primary stageⅠ/ⅡE UAT ENKTCL patients admitted to General Hospital of PLA between June 2009 and June 2020 was analyzed retrospectively,including clinical characteristics,approaches,regimens and efficacy.Results Sixty-one patients were enrolled.Treatment strategies were chemotherapy alone and chemotherapy followed by radiotherapy.The complete remission(CR)rate was 62.5%and 82.2%(χ^(2)=1.714,P=0.190).The chemotherapy regimens involved the anthracycline group,anthracycline combined with L-asparaginase group and the non-anthracycline combined with asparaginase group.The corresponding CR rate was 46.7%,72.7%,91.7%(χ^(2)=91.155,P<0.001),5-year OS rate was 46.7%,68.2%,94.4%(χ^(2)=9.893,P=0.007),and 5-year PFS rate was 33.3%,63.6%,79.7%(χ^(2)=8.575,P=0.014)in the three groups.The therapeutic effects of the nonanthracycline combined with asparaginase group were superior to the other two groups and the differences were statistically significant(P=0.007,0.005,0.002,0.004).Conclusion The chemotherapy regimen for primary stageⅠ/ⅡE UAT-ENKTCL patients based on non anthracycline combined with L-asparaginase regimens can significantly improve the efficacy.