Chim Chor-Sang, Ma Shing-Yan, Au Wing-Yan, Choy Carolyn, Lie Albert K W, Liang Raymond, Yau Chun-Chung, Kwong Yok-Lam
Department of Medicine,University of Hong Kong, Queen Mary Hospital, Hong Kong.
Blood. 2004 Jan 1;103(1):216-21. doi: 10.1182/blood-2003-05-1401. Epub 2003 Aug 21.
Nasal natural killer (NK) cell lymphoma is rare, so that its optimal therapy, long-term outcome, and prognostic factors are unclear. Data on 52 men and 15 women with well-characterized nasal NK cell lymphomas were analyzed retrospectively to define the impact of primary therapy on remission and long-term outcome and the validity of the International Prognostic Index (IPI). Most (84%) had stage I/II disease with an IPI score of 1 or less (52%). Seven patients received radiotherapy only; 47 patients received anthracycline-containing chemotherapy plus consolidation radiotherapy; and 12 patients received nonanthracycline-containing chemotherapy plus radiotherapy. The overall complete remission (CR) rate was 64.2%; the 20-year overall survival (OS) and disease-free survival (DFS) rates were 37.1% and 33.5%, respectively. Front-line radiotherapy was apparently better than chemotherapy for CR (100% versus 59%, P =.04) and OS (83.3% versus 32.0%, P =.03). Relapses occurred in 4 radiotherapy-treated (all local) and 14 chemotherapy-treated patients (9 local, 4 systemic). Among these, 5 late relapses (4 local, 1 systemic) occurred at 170 months (range, 92-348 months) from CR. The IPI score was of prognostic significance for the whole group (IPI <or= 1 superior to IPI >or= 2 for 20-year OS: 57.4% versus 27.6%, P = 0.012), as well as for patients treated with chemotherapy/radiotherapy (IPI <or= 1 superior to IPI >or= 2 for CR: 76.7% versus 35.7%, P =.017; and 10-year OS: 63.8% versus 26.8%, P =.003).
鼻型自然杀伤（NK）细胞淋巴瘤较为罕见，因此其最佳治疗方案、长期预后及预后因素尚不清楚。我们对52例男性和15例女性特征明确的鼻型NK细胞淋巴瘤患者的数据进行了回顾性分析，以确定初始治疗对缓解和长期预后的影响以及国际预后指数（IPI）的有效性。大多数患者（84%）为Ⅰ/Ⅱ期疾病，IPI评分≤1分（52%）。7例患者仅接受放疗；47例患者接受含蒽环类药物的化疗加巩固放疗；12例患者接受不含蒽环类药物的化疗加放疗。总体完全缓解（CR）率为64.2%；20年总生存（OS）率和无病生存（DFS）率分别为37.1%和33.5%。一线放疗在CR（100%对59%，P = 0.04）和OS（83.3%对32.0%，P = 0.03）方面明显优于化疗。4例接受放疗的患者（均为局部复发）和14例接受化疗的患者（9例局部复发，4例全身复发）出现复发。其中，5例晚期复发（4例局部复发，1例全身复发）发生在CR后的170个月（范围92 - 348个月）。IPI评分对整个组具有预后意义（20年OS：IPI≤1分优于IPI≥2分：57.4%对27.6%，P = 0.012），对于接受化疗/放疗的患者也是如此（CR：IPI≤1分优于IPI≥2分：76.7%对35.7%，P = 0.017；10年OS：63.8%对26.8%，P = 0.003）。
