[鼻腔原发性非霍奇金淋巴瘤的预后因素——附129例报告]
[Prognostic factors of primary non-Hodgkin's lymphoma of the nasal cavity--a report of 129 cases].
作者信息
Yao Bo, Li Ye-Xiong, Fang Hui, Jin Jing, Liu Xin-Fan, Yu Zi-Hao
机构信息
Department of Radiation Oncology, Cancer Hospital/Cancer Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, P. R. China.
出版信息
Ai Zheng. 2006 Apr;25(4):465-70.
BACKGROUND & OBJECTIVE: The prognosis of primary non-Hodgkin's lymphoma (NHL) of the nasal cavity was poor, and the distant metastasis and local relapse rates are high. This study was to analyze the prognostic factors of this disease.
METHODS
Clinical data of 129 patients with pathologically confirmed nasal NHL, treated from Jan. 1996 to Dec. 2002, were retrospectively reviewed. Of the 129 patients, 116 were diagnosed as nasal NK/T-cell lymphoma. According to the Ann Arbor staging system, 102 patients had stage IE disease, 22 stage IIE, and 5 stage IVE. Among the 124 patients with stage IE or IIE disease, 22 received radiotherapy alone, 7 received chemotherapy alone, and 95 received combined modality therapy (CMT). Of the patients received CMT, 45 received radiotherapy followed by chemotherapy, and 50 received chemotherapy followed by radiotherapy. The stage IVE patients received chemotherapy with or without radiotherapy.
RESULTS
The 5-year overall survival (OS) and disease-freely survival (DFS) rates for all patients were 68.0% and 55.8%, respectively. The 5-year OS and DFS rates were 71.7% and 60.9% for stage IE patients, and 70.6% and 47.0% for stage IIE patients, respectively (P>0.05). The 5-year OS and DFS rates were significantly higher in the patients who achieved complete response (CR) than in those who didn't (83.1% vs. 18.0%, 68.0% vs. 15.5%, P<0.01). The 5-year OS rates of the patients with international prognostic index (IPI) score of 0, 1, and > or =2 were 81.1%, 60.1%, and 14.3% (P<0.01), respectively; the 5-year DFS rates were 68.8%, 44.6%, and 22.5% (P<0.01), respectively. Thirty-eight patients developed progression or relapse, with distant extranodal dissemination (78.9%) as the primary pattern of failure. Univariate analysis showed that CR rate, PS, IPI, and modified IPI were related to prognosis. Multivariate analysis showed that CR rate was an independent prognostic factor.
CONCLUSIONS
CR rate after treatment is an important prognostic factor of nasal NHL. Distant metastasis is the main failure pattern of nasal NHL.
背景与目的
鼻腔原发性非霍奇金淋巴瘤（NHL）预后较差，远处转移率和局部复发率较高。本研究旨在分析该疾病的预后因素。
方法
回顾性分析1996年1月至2002年12月期间收治的129例经病理确诊的鼻腔NHL患者的临床资料。129例患者中，116例被诊断为鼻腔NK/T细胞淋巴瘤。根据Ann Arbor分期系统，102例患者为IE期，22例为IIE期，5例为IVE期。在124例IE期或IIE期患者中，22例仅接受放疗，7例仅接受化疗，95例接受综合治疗（CMT）。接受CMT的患者中，45例先接受放疗后化疗，50例先接受化疗后放疗。IVE期患者接受化疗，部分联合放疗。
结果
所有患者的5年总生存率（OS）和无病生存率（DFS）分别为68.0%和55.8%。IE期患者的5年OS率和DFS率分别为71.7%和60.9%，IIE期患者分别为70.6%和47.0%（P>0.05）。达到完全缓解（CR）的患者5年OS率和DFS率显著高于未达到CR的患者（83.1%对18.0%，68.0%对15.5%，P<0.01）。国际预后指数（IPI）评分为0、1和≥2的患者5年OS率分别为81.1%、60.1%和14.3%（P<0.01）；5年DFS率分别为68.8%、44.6%和22.5%（P<0.01）。38例患者出现病情进展或复发，远处结外播散（78.9%）是主要的失败模式。单因素分析显示，CR率、体能状态（PS）、IPI和改良IPI与预后相关。多因素分析显示，CR率是独立的预后因素。
结论
治疗后的CR率是鼻腔NHL的重要预后因素。远处转移是鼻腔NHL的主要失败模式。
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