LOP化疗联合放疗治疗早期鼻NK/T细胞淋巴瘤的临床分析

Clinical observation of LOP chemotherapy combined with radiotherapy in the treatment of early nasal NK/T cell lymphoma

目的:探讨LOP(门冬酰胺酶+长春新碱+地塞米松)化疗联合放疗治疗鼻NK/T细胞淋巴瘤的疗效及其安全性。方法:选取2012-02-2016-02期间收治的60例鼻NK/T细胞淋巴瘤患者为研究对象,将其分为A组和B组,每组各30例。所有患者采用联合化疗与调强适形放疗(IMRT)相结合的综合治疗方案。A组化疗应用LOP方案,B组采用CHOP(环磷酰胺+吡柔比星+长春新碱+地塞米松)方案。比较2种不同诊疗方案的近期疗效、远期疗效以及不良反应情况。结果:60例患者的临床表现主要包括鼻塞(81.67%),并伴有发热、头痛、鼻出血以及流涕等。病变累及1个部位者41例(68.33%),累及多个部位者21例(35.00%)。在总缓解率方面,A组为93.33%,B组为66.67%,A组高于B组(P<0.05)。在不良反应发生率方面,A组在骨髓抑制、消化道反应、低蛋白反应方面的发生率均低于B组(P<0.05)。随访3年,A组共有3例患者死亡,B组共有11例患者死亡,A组的3年生存率高于B组(P<0.05)。结论:相较于CHOP+IMRT方案,采用LOP+IMRT方案对鼻NK/T细胞淋巴瘤患者进行治疗,其总缓解率和生存率更高,不良反应更低,值得推广。

Objective:To investigate the efficacy and safety of LOP(asparaginase+vincristine+dexamethasone)chemotherapy combined with radiotherapy in patients with nasal NK/T cell lymphoma.Method:Sixty patients with nasal NK/T cell lymphoma admitted to our hospital from February 2012 to February 2016 were selected as the study subject.They were randomly divided into group A and group B,30 cases in each group.All patients were treated with combined chemotherapy and IMRT(intensity modulated conformal radiotherapy).The LOP regimen was used in group A and the CHOP(cyclophosphamide+pirarubicin+vincristine+dexamethasone)regimen was used in group B.The short-term efficacy,long-term efficacy and adverse reactions of the two groups were compared.Result:The clinical manifestations of 60 patients mainly included nasal obstruction(81.67%),accompanied by fever,headache,nosebleed and runny nose.Forty-one patients(68.33%)had only one site of lesion,and 21 patients(35.00%)had multiple sites of lesions.In terms of total remission rate,it was significantly higher in group A than that in group B(93.33%vs.66.67%,P<0.05).In terms of adverse reactions,the incidence of bone marrow suppression,gastrointestinal reaction and low-protein reaction was significantly lower in group A than that in group B(P<0.05).Three patients died in group A and 11 patients died in group B during the 3-year follow-up.The 3-year survival rate of group A was higher than that of group B(P<0.05).Conclusion:Compared with CHOP+IMRT regimen,the LOP+IMRT regimen for nasal NK/T-cell lymphoma patients resulted in higher overall remission rate,survival rate and lower adverse reactions,so it is worth in clinical promotion.