摘要
目的探讨Ⅰ~Ⅱ期上呼吸消化道自然杀伤T细胞(NK/T细胞)淋巴瘤累及鼻腔与否对于预后的影响。方法2006年1月~2012年6月本院连续收治的初治上呼吸消化道NK/T细胞淋巴瘤患者211例,其中Ⅰ期179例、Ⅱ期32例;累及鼻腔189例,包括局限于鼻腔81例,同时侵犯鼻腔及邻近组织者108例,未累及鼻腔22例;患者接受单纯放射治疗(简称放疗)或“三明治法”联合放射化学治疗(简称放化疗);化学治疗(简称化疗)均采用CHOP方案,放疗中位剂量为54 Gy。结果中位随访92.7个月(76.9~124.9个月),211例患者生存分析显示,5年生存率为72.1%,其中Ⅰ期5年生存率为73.7%,Ⅱ期5年生存率为63.5%(P=0.023);鼻腔累及者未发现病灶侵犯范围大小对于预后的影响;鼻腔累及者与鼻腔未累及者有显著差别,2组治疗后的5年总生存率(OS)分别为75.5%和42.9%。结论虽然同属于上呼吸消化道NK/T细胞淋巴瘤,未累及鼻腔者远比累及鼻腔者预后差,临床上需区别对待,考虑更激进的治疗手段和更有效的化疗方案。
Objective To investigate the effects of nasal cavity involvement ofⅠ/Ⅱupper aerodigestive tract natural killer T cell lymphoma(UNKTL)on prognosis.Methods Data of 211 initially-treated UNKTL patients who were consecutively admitted between January,2006 and June,2012 were analyzed retrospectively.Among them,179 cases were in stageⅠand 32 cases in stageⅡ;189 cases had a nasal-involvement,which included 81 cases with the lesion limited in nasal cavity and 108 cases with nasal cavity and adjacent tissues both affected;and 22 cases do not had a nasal-involvement.These patients received radiotherapy alone or“sandwich”radiotherapy plus chemotherapy.Chemotherapy was performed using the CHOP regimen and the median radiotherapy dose was 54 Gy.Results The median follow-up time was 92.7 months(76.9~124.9 months).For the survival analysis,the five-year survival rate of 211 patients was 72.1%,of which those values for stagesⅠandⅡcases were 73.7%and 63.5%respectively(P=0.023).For nasal-involvement patients,no effects of the tumor invasion extent on disease prognosis were observed.There were significant differences between nasal involvement and non-involvement patients,and the overall survival(OS)after five years of treatment in both groups were 75.5%and 42.9%respectively.Conclusions Although both nasal involvement and non-involvement UNKTL tumors are of upper aerodigestive tract NK/T-cell lymphoma,not nasal involvement UNKTL is much worse in disease prognosis than nasal-involvement UNKTL,thus they should be treated with different methods in clinical practice.For non nasal involvement UNKTL,more aggressive treatments and more effective chemotherapy regimens should be adopted.
作者
王天
田姝
丁浩
WANG Tian;TIAN Shu;DING Hao(Department of Radiation Oncology,Eye Ear Nose and Throat Hospital of Fudan University,Shanghai 200031,China)
出处
《中国眼耳鼻喉科杂志》
2020年第2期88-93,共6页
Chinese Journal of Ophthalmology and Otorhinolaryngology
