Clinical differences between primary nasopharyngeal NK ／T?cell lymphoma and primary nasal cavity NK ／T?cell lymphoma with nasopharynx extension
10.3760／cma.j.issn.0253?3766.2019.01.010
- VernacularTitle:鼻咽原发和鼻咽受累结外鼻型NK／T细胞淋巴瘤的临床病理特征和预后
- Author:
Weixin LIU
1
;
Yueping LIU
;
Jing JIN
;
Shulian WANG
;
Hui FANG
;
Hua REN
;
Yongwen SONG
;
Bo CHEN
;
Ningning LU
;
Ning LI
;
Yuan TANG
;
Shunan QI
;
Yu TANG
;
Weihu WANG
;
Yexiong LI
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院放疗科 100021
- Keywords:
Lymphoma,NK／T?cell;
Radiotherapy;
Chemotherapy;
Prognosis
- From:
Chinese Journal of Oncology
2019;41(1):56-62
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical and prognostic differences between primary nasopharyngeal natural killer (NK)／T?cell lymphoma (NP NKTCL) and extranodal NK／T?cell lymphoma of the nasal cavity with nasopharynx extension ( N?NP NKTCL). Methods A total of 89 patients with NP NKTCL and 113 patients with N?NP NKTCL from January 2000 to June 2015 were retrospectively analyzed. Clinical and pathological features, treatment responses and prognosis were compared between the two groups. Results NP NKTCL patients showed similar clinicopathological features with those with N?NP NKTCL, except that the former had a relative low proportion of elevated lactate dehydrogenase (LDH) levels (28.1% vs. 41.6%; P ＝ 0.001 ). Both of two groups presented with high proportion of cervical lymph node involvement (55.1% and 42.5%; P＝0.076). The 5?year overall survival (OS) rates in these two groups were 63.2% and 54.6%, respectively, whereas 5?year progress?free survival ( PFS) rates were 50.7% and 45.6%, respectively. For the patients with stageⅠandⅡ, the 5?year OS and PFS rates in these two groups were 68.8% and 55.7% as well as 55.6% and 47.2%, respectively. These were no statistically significant differences between two groups (all P＞0.05).The complete response (CR) rate after initial chemotherapy in NP NKTCL group was 43.8%, which was significant higher than that of 19.6% in N?NP NKTCL group (P＝0.006). Additionally, the CR rate after primary radiotherapy was 63.4% and 62.7%, respectively ( P＝0.629). The NP NKTCL patients with stage Ⅰ and Ⅱ who accepted radiotherapy with or without chemotherapy had similar survival times with chemotherapy alone, showing the 5?year OS rates of 70.5% and 33.3%(P＝0.238), as well as the 5?year PFS rates of 56.7% and 33.3%, respectively (P＝0.431). Similar results were found in N?NP NKTCL group, the 5?year OS rates for patients with radiotherapy with or without chemotherapy and chemotherapy alone were 57.4% and 33.3%( P＝0.246), while the 5?year PFS rates were 49.3% and 16.7%(P＝0.177), respectively. Besides, the relapse pattern of NP NKTCL and N?NP NKTCL groups was also similar, mainly involving the distant extra?nodal organs followed by lymph nodes. Conclusion The patients with N?NP NKTCL and NP NKTCL showed similar clinical and prognostic features, however, the initial response to chemotherapy was different.
