Department of Radiation Oncology, Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Cancer. 2012 Mar 15;118(6):1593-8. doi: 10.1002/cncr.26452. Epub 2011 Aug 11.
Nasal diffuse large B-cell lymphoma (DLBCL) is rare. The objective of this study was to evaluate the clinical features and treatment outcomes of patients with nasal DLBCL.
Twenty-five patients were included in the study. All patients received combination chemotherapy with or without radiotherapy.
Patients with nasal DLBCL usually were older and were predominantly men with early stage disease, low frequency of B symptoms and elevated lactate dehydrogenase (LDH), good performance status, and a low-risk international prognostic index (IPI) score. The overall response rate after initial treatment was 76%, the 3-year overall survival (OS) rate for the whole group was 44%, and the median OS was 35 months. Performance status and IPI were significant prognostic factors for OS. For patients with IPI scores of 0 or 1, the 3-year OS rate was 54%, and the median OS was 52 months compared with 17% and 11 months, respectively, for patients with IPI scores of 2 or 3 (P = .033). The prognosis for patients who achieved a complete response (CR) was significantly better than that for patients who did not achieve a CR. Extranodal spread was the primary pattern of failure.
The current results indicated that primary nasal DLBCL appears to have distinct clinical features; its poor outcome and propensity for extranodal failure illustrate the need for innovative therapies.
鼻腔弥漫性大 B 细胞淋巴瘤（DLBCL）较为罕见。本研究旨在评估鼻腔 DLBCL 患者的临床特征和治疗结局。
共纳入 25 例患者。所有患者均接受了联合化疗加或不加放疗。
鼻腔 DLBCL 患者通常年龄较大且以男性为主，疾病处于早期、B 症状频率低、乳酸脱氢酶（LDH）升高、一般状况良好且国际预后指数（IPI）评分低危。初始治疗后的总缓解率为 76%，全组 3 年总生存率（OS）为 44%，中位 OS 为 35 个月。一般状况和 IPI 是 OS 的显著预后因素。对于 IPI 评分为 0 或 1 的患者，3 年 OS 率为 54%，中位 OS 为 52 个月，而 IPI 评分为 2 或 3 的患者分别为 17%和 11 个月（P =.033）。达到完全缓解（CR）的患者预后明显优于未达到 CR 的患者。结外扩散是失败的主要模式。
目前的结果表明，原发性鼻腔 DLBCL 具有独特的临床特征；其不良预后和结外扩散倾向表明需要创新疗法。
