Early stage nasal NK/T cell lymphoma: an analysis of efficacy of chemoradiotherapy and prognostic factors in 74 cases
10.3760/cma.j.issn.1009-9921.2017.06.005
- VernacularTitle:早期鼻腔NK/T细胞淋巴瘤74例放化疗效果及预后因素分析
- Author:
Ping LU
;
Shengmin LAN
;
Ruyuan GUO
- Keywords:
Lymphoma,extranodal NK-T-cell;
Radiotherapy;
Drug therapy;
Prognosis
- From:
Journal of Leukemia & Lymphoma
2017;26(6):340-344
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the therapeutic effect of chemoradiotherapy on 74 patients with early stage nasal NK/T cell lymphoma and their prognostic factors. Methods 74 patients with early nasal NK/T cell lymphoma that were treated in Shanxi Cancer Hospital from January 2005 to November 2013 were analyzed retrospectively. Among them, 28 patients received radiotherapy alone, 10 patients received concurrent chemoradiotherapy and 36 patients received alone. In 36 patients with chemotherapy, 25 cases were treated with CHOP (cyclophosphamide+doxorubicin+vincristine+prednisone), 4 cases were treated with DICE (dexamethasone + etoposide + cisplatin + isofosfamide) and 7 cases were treated with L-asparaginase +dexamethasone+ifosfamide+methotrexate + etoposide. According to Ann Arbor classification, 60 patients were stage Ⅰ and 14 patients were stage Ⅱ. Kaplan-Meier test was used for survival analysis, log-rank method was used for single factor analysis, and Cox proportional hazard model was used for multi factor analysis. Results All patients completed the treatment. 24 patients were died. 3-year overall survival (OS) rate was 72.5 %. The OS rate in simple radiotherapy group was 92.7 %, simple chemotherapy group was 62.3%, and the concurrent chemoradiotherapy group was 79.1%. The OS rates in simple radiotherapy and simple chemotherapy groups had statistical difference (χ2 = 10.676, P< 0.05), The difference in the simple radiotherapy and concurrent chemoradiotherapy groups was not statistically significant (χ2= 2.019, P> 0.05). In radiotherapy alone group, the rates of complete remission (CR), partial remission (PR), stable rate and progress rate of disease were 89.3%(25/28), 7.1%(2/28), 3.6%(1/28), and 0;in chemotherapy alone group, they were 55.6 % (20/36), 25.0 % (9/36), 8.0 % (3/36), and 11.1 % (4/36); in concurrent chemoradiotherapy group, they were 80.0 % (8/ 10), 10.0 % (1/10), 0, and 10.0 % (1/10), respectively. There was significant difference between radiotherapy group and chemotherapy group (χ2 = 8.584, P< 0.05); there was no significant difference between radiotherapy group and concurrent chemoradiotherapy group (χ2=0.556, P>0.05). Single factor analysis showed that age, ECOG score, B symptoms, Ann Arbor stage, IPI and treatment options were related to the prognosis. Multivariate analysis showed that age, ECOG score and Ann Arbor stage were independent prognostic factors. Conclusions As the main treatment method of early stage nasal NK/T cell lymphoma, radiotherapy can obtain good short-term curative effect and long-term curative effect. Age, ECOG score, B symptoms, Ann Arbor stage, IPI and treatment options are related to survival prognosis. Age, ECOG score and Ann Arbor stage are the independent prognostic factors.
