摘要
目的探讨放疗在Ⅰ～Ⅱ。期结外鼻型NK／T细胞淋巴瘤综合治疗中的作用及其预后因素。方法回顾分析1990-2006年收治的177例患者，其中单纯化疗37例（中位4周期），化疗（中位3周期）＋放疗（中位剂量52Gy）128例，单纯放疗（中位剂量58Gy）6例，放疗（中位剂量54Gy）＋化疗（中位5周期）6例。结果首程化疗后有效（CR＋PR）率为65．3％，接受放疗后的为92．8％（X2=28．63，P〈0．01）。接受放疗的局部控制率（80．9％）优于单纯化疗者（50．0％；X2=14．39，P〈0．01）；5年总生存率分别为53．4％和18．3％（X2=23．38，P〈0．01），无进展生存率分别为45．0％和10．9％（X2=23．46，P〈0．01）。首程化疗后有效与无效（SD＋PD）者接受放疗的局部控制率、5年总生存率均明显优于单纯化疗者[83．5％与76．2％优于50．0％（X2=14．13，P〈0．01；x。=5．78，P〈0．01）、56．2％与48．6％优于18．3％（x2=28．87，P〈0．05；X2=4．80，P〈0．05）]。结论放疗比化疗能显著提高早期结外鼻型NK／T细胞淋巴瘤的有效率、局部控制率和生存率，对化疗后局部肿瘤无效者也有显著疗效。根治性放疗应成为早期鼻型NK／T细胞淋巴瘤的首选治疗手段。
Objective To investigate the role of radiotherapy （RT） and prognostic factors in the combined modality treatment （CMT） of patients with stage ⅠE - ⅡE extranodal nasal type NK/T-cell lym- phoma. Methods From Dec. 1990 to Dee. 2006,177 patients who were diagnosed and treated in our hospital were retrospectively analyzed,induding 37 received chemotherapy （CT） alone （median 4 cycles） , 128 received CT （median 3 cycles） followed by RT （median 52 Gy） ,6 received RT alone （median 58 Gy） and 6 received RT （ median 54 Gy） followed by CT （ median 5 cycles）. Results The overall response （ CR ＋ PR） rate after initial CT was 60.8% compared with 83.8% after RT （ X2 = 28.63 ,P 〈 0.01 ）. The 5-year overall survival （OS） and progress-free survival （PFS） rates were 46.2% and 36.8% ,respectively. The local control rates were 80.9% for RT （alone or with CMT） and 50.0% for CT alone （X2 = 14.39,P 〈 0.01 ） , and corresponding 5-year OS and PFS were 53.4% vs. 18.3% （ X2 = 23.38,P 〈 0.01 ） and 45.0% vs. 10.9% （ X2 = 23.46, P 〈 0.01 ） , respectively. Compared with CT alone, the following definitive RT for patients who achieved response or not after initial CT significantly improved the local control [ 83.5% , 76.2% vs. 50.0%（X2 =14.13,P〈0.01;X2 =5.78,P〈0.01）] and5-year OS[56.2%,48.6% vs. 18.3%（X2 =28.87,P〈0.05;X2 =4.80,P〈0.05）]. Conclusions Compared wiLh CT alone,RT achieves better tumor response, local control and survival of patients not only with tumor response but also with local progression after CT. Definitive RT should be the reasonable choice of treatment for early stage extranodal nasal type NK/T-cell lymphoma.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2009年第4期285-289,共5页
Chinese Journal of Radiation Oncology
基金
广东省医学科研基金（A2006232）
关键词
淋巴瘤/放射疗法
淋巴瘤/化学疗法
综合治疗
预后
Lymphoma/radiotherapy
Lymphoma/ehemotherapy
Combined modality treat-ment
Prognosis
