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皮肤或软组织结外自然杀伤/T 细胞淋巴瘤:多国回顾性分析的治疗建议。

Extranodal natural killer/T-cell lymphoma from skin or soft tissue: suggestion of treatment from multinational retrospective analysis.

机构信息

Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.

Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Ann Oncol. 2012 Oct;23(10):2703-2707. doi: 10.1093/annonc/mds096. Epub 2012 Apr 29.

Abstract

BACKGROUND

Clinical features and outcomes of extranodal natural killer/T-cell lymphoma (ENKL) arising from extranasal sites are not fully understood. The purpose of this study was to study the prognosis and treatment outcome of skin/soft tissue primary ENKL.

PATIENTS AND METHODS

This multicenter retrospective study included 48 patients with skin/soft tissue primary ENKL diagnosed from 1993 to 2010.

RESULTS

Patients with Ann Arbor stage I, T1-2N0M0 by International Society for Cutaneous Lymphomas-European Organization of Research and Treatment of Cancer TNM (tumour-node-metastasis) stage, International prognostic index score of 0-1, and a Korean prognostic index (KPI) score of 0-1 were associated with better survival. Four of five patients with T1-2N0M0 disease achieved complete response with radiation alone. In disseminated disease, only 6 of 13 patients responded to anthracycline-containing chemotherapy, and all the two patients receiving SMILE showed response.

CONCLUSION

In conclusion, we identified the prognostic value of KPI, and we suggest a treatment recommendation according to the TNM (tumour-node-metastasis) stage. Radiotherapy with/without chemotherapy seemed to be optimal in localized disease. In advanced stages, a more aggressive treatment regimen with newer agents should be sought.

摘要

背景

发生于结外部位的结外自然杀伤/T 细胞淋巴瘤(ENKL)的临床特征和预后尚不完全清楚。本研究的目的是研究皮肤/软组织原发性 ENKL 的预后和治疗结果。

患者和方法

这是一项多中心回顾性研究,纳入了 1993 年至 2010 年间诊断为皮肤/软组织原发性 ENKL 的 48 例患者。

结果

Ann Arbor 分期为 I 期、国际结外淋巴瘤研究组织-欧洲癌症研究与治疗组织 TNM(肿瘤-淋巴结-转移)分期 T1-2N0M0、国际预后指数评分为 0-1 分、韩国预后指数(KPI)评分为 0-1 分的患者生存情况较好。5 例 T1-2N0M0 疾病患者中有 4 例单独接受放疗即可达到完全缓解。在播散性疾病中,仅 13 例接受含蒽环类药物化疗的患者中有 6 例有反应,2 例接受 SMILE 治疗的患者均有反应。

结论

总之,我们确定了 KPI 的预后价值,并根据 TNM(肿瘤-淋巴结-转移)分期提出了治疗建议。局限性疾病采用放疗联合/不联合化疗似乎是最佳选择。在晚期,应寻求更具侵袭性的新药物治疗方案。

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