Wang Biyun, Lu Jiade J, Ma Xuejun, Guo Ye, Lu Hongfen, Hong Xiaonan, Li Jin
Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai, People's Republic of China.
Leuk Lymphoma. 2007 Feb;48(2):396-402. doi: 10.1080/10428190601059795.
To evaluate the outcome of CHOP chemotherapy and radiotherapy in Stage IE and IIE nasal natural killer (NK)/T-cell lymphoma, 53 patients with stage IE and IIE nasal NK/T-cell lymphoma were studied. By the Ann Arbor Lymphoma Staging Classification, 41 patients (77%) had Stage IE disease and 12 patients (23%) had Stage IIE disease. All patients were treated curatively using chemotherapy, followed by radiotherapy. Chemotherapy consisted of up to six cycles of the standard CHOP based regimen. The median radiation dose to the tumor bed was 45 Gy for all patients. The median follow-up for all 39 surviving patients was 30.2 months (range, 6 - 104 months). Twenty-six patients had complete response after chemotherapy, and all patients who completed first line chemotherapy achieved complete response after radiotherapy. The 2-year overall survival and progression-free survival rates were 75.6% and 61.8%, respectively. Multivariate analysis revealed that perforation as a presenting symptom, elevated pretreatment serum lactate dehydrogenase level, and ECOG performance status >or=2 were significant independent prognostic factors for this group of patients. Combined chemotherapy followed by involved field radiation produced suboptimal outcome for patients with early stage nasal NK/T-cell lymphoma. Further investigations, preferably prospective clinical trials, for more efficacious treatment strategies are needed to improve the treatment outcome of this malignancy.
为评估CHOP化疗联合放疗对IE期和IIE期鼻腔自然杀伤（NK）/T细胞淋巴瘤的治疗效果，对53例IE期和IIE期鼻腔NK/T细胞淋巴瘤患者进行了研究。根据Ann Arbor淋巴瘤分期分类，41例患者（77%）为IE期疾病，12例患者（23%）为IIE期疾病。所有患者均接受根治性化疗，随后进行放疗。化疗采用基于标准CHOP方案的最多六个周期。所有患者肿瘤床的中位放疗剂量为45 Gy。39例存活患者的中位随访时间为30.2个月（范围6 - 104个月）。26例患者化疗后完全缓解，所有完成一线化疗的患者放疗后均达到完全缓解。2年总生存率和无进展生存率分别为75.6%和61.8%。多因素分析显示，穿孔作为首发症状、治疗前血清乳酸脱氢酶水平升高以及东部肿瘤协作组（ECOG）体能状态≥2是该组患者重要的独立预后因素。对于早期鼻腔NK/T细胞淋巴瘤患者，联合化疗后进行受累野放疗的效果欠佳。需要进一步开展研究，最好是前瞻性临床试验，以寻找更有效的治疗策略，从而改善这种恶性肿瘤的治疗效果。
