Li Ye-Xiong, Fang Hui, Liu Qing-Feng, Lu Jiade, Qi Shu-Nan, Wang Hua, Jin Jing, Wang Wei-Hu, Liu Yue-Ping, Song Yong-Wen, Wang Shu-Lian, Liu Xin-Fan, Feng Xiao-Li, Yu Zi-Hao
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People's Republic of China.
Blood. 2008 Oct 15;112(8):3057-64. doi: 10.1182/blood-2008-05-160176. Epub 2008 Aug 1.
The clinical characteristics and prognosis remain unclear for nasal-type NK/T-cell lymphoma of Waldeyer ring (WR-NKTL). The aim of this study is to determine the clinical features and outcome. Ninety-one patients with WR-NKTL were reviewed. According to the Ann Arbor system, 15, 56, 12, and 8 patients had stage I, II, III, and IV. Of patients with stage I and II, 54 received combined chemotherapy and radiotherapy (CMT), 13 received radiotherapy alone, and 4 patients received chemotherapy alone. All 20 patients with stage III/IV received primary chemotherapy. The disease is characterized by predominance in young males, good performance, a propensity for nodal involvement, frequent stage II through IV diseases, low frequency of elevated LDH, low-risk international prognostic index (IPI), high sensitivity to radiotherapy, and intermediate sensitivity to chemotherapy. The 5-year overall survival and progression-free survival for all patients were 65% and 51%, respectively. The age, B symptoms, stage, and IPI were important prognostic factors. CMT tended to improve the survival compared with radiotherapy alone for patients with stage I and II diseases. Both nodal involvement and distant extranodal dissemination were the primary failure patterns. WR-NKTL appears to have distinct clinical characteristics and favorable outcomes.
Waldeyer环鼻型NK/T细胞淋巴瘤(WR-NKTL)的临床特征和预后仍不明确。本研究旨在确定其临床特征和预后。回顾了91例WR-NKTL患者。根据Ann Arbor分期系统,Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者分别有15例、56例、12例和8例。Ⅰ/Ⅱ期患者中,54例接受了化疗联合放疗(CMT),13例仅接受放疗,4例仅接受化疗。所有20例Ⅲ/Ⅳ期患者均接受了一线化疗。该疾病的特点是好发于年轻男性,一般状况良好,倾向于累及淋巴结,Ⅱ至Ⅳ期疾病常见,乳酸脱氢酶升高频率低,国际预后指数(IPI)低危,对放疗高度敏感,对化疗中度敏感。所有患者的5年总生存率和无进展生存率分别为65%和51%。年龄、B症状、分期和IPI是重要的预后因素。对于Ⅰ/Ⅱ期疾病患者,与单纯放疗相比,CMT倾向于提高生存率。淋巴结受累和远处结外播散均为主要的失败模式。WR-NKTL似乎具有独特的临床特征和良好的预后。