Isobe Koichi, Uno Takashi, Tamaru Jun-ichi, Kawakami Hiroyuki, Ueno Naoyuki, Wakita Hisashi, Okada Jun-ichi, Itami Jun, Ito Hisao
Department of Radiology, Chiba University Hospital, Chiba, Japan.
Cancer. 2006 Feb 1;106(3):609-15. doi: 10.1002/cncr.21656.
The objective of this study was to investigate the correlation between local recurrence and radiotherapeutic parameters, including dose and RT radiotherapy (RT) field.
The current study included 35 patients who were diagnosed with immunohistochemically confirmed nasal natural killer (NK)/T-cell lymphoma between 1976 and 2004. There were 21 males and 14 females, and they ranged in age from 18 years to 76 years (median, 51 yrs). The primary tumor originated in the nasal cavity in 28 patients, and 32 patients had Stage I disease. Seventeen patients received treatment solely with RT, and the remaining 18 patients received a combination of chemotherapy and RT. The median tumor dose was 50 grays (Gy) (range, 22-60 Gy). Twenty-seven patients received RT to include all macroscopic lesions, all paranasal sinuses, the palate, and the nasopharynx. Eight patients received RT to all macroscopic lesions with generous margins.
A complete remission (CR) or a CR/unconfirmed was achieved in 28 patients (80%). The 5-year overall survival (OAS) rate, disease-free survival (DFS) rate, and local control probability (LCP) were 47.3%, 42.9%, and 65.2%, respectively. Patients who received RT only to macroscopic lesions fared less well in terms of LCP (LCP 5 years, 71.9% vs. 41.7%; P=0.007). The difference in RT field also affected both the OAS rate and the DFS rate. Patients who received RT doses>or=50 Gy tended to achieve favorable local control.
In the management of nasal NK/T-cell lymphoma, the RT field affected treatment outcomes. RT doses>or=50 Gy resulted in favorable local control.
本研究的目的是调查局部复发与放射治疗参数之间的相关性，这些参数包括剂量和放疗（RT）野。
本研究纳入了35例在1976年至2004年间经免疫组织化学确诊为鼻腔自然杀伤（NK）/T细胞淋巴瘤的患者。其中男性21例，女性14例，年龄范围为18岁至76岁（中位数为51岁）。28例患者的原发肿瘤起源于鼻腔，32例患者为I期疾病。17例患者仅接受放疗，其余18例患者接受化疗与放疗联合治疗。中位肿瘤剂量为50格雷（Gy）（范围为22 - 60 Gy）。27例患者接受的放疗范围包括所有肉眼可见病变、所有鼻窦、腭部和鼻咽部。8例患者接受的放疗范围为所有肉眼可见病变并带有足够的边界。
28例患者（80%）实现了完全缓解（CR）或CR/未确认缓解。5年总生存率（OAS）、无病生存率（DFS）和局部控制率（LCP）分别为47.3%、42.9%和65.2%。仅对肉眼可见病变进行放疗的患者在LCP方面表现较差（5年LCP，71.9%对41.7%；P = 0.007）。放疗野的差异也影响了OAS率和DFS率。接受放疗剂量≥50 Gy的患者倾向于获得良好的局部控制。
在鼻腔NK/T细胞淋巴瘤的治疗中，放疗野影响治疗结果。放疗剂量≥50 Gy可实现良好的局部控制。
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