Lee Hyun Jin, Lee Sang-Wook, Suh Cheolwon, Huh Jooryung, Yoon Sang Min, Kim Young Seok, Kim Su San, Kim Jong Hoon, Choi Eun Kyung, Ahn Seung Do
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Radiat Oncol J. 2011 Sep;29(3):174-80. doi: 10.3857/roj.2011.29.3.174. Epub 2011 Sep 30.
To evaluate the radiotherapy treatment outcome of patients in stage IE and IIE nasal natural killer/T-cell lymphoma.
From August 1999 to August 2009, 46 patients with stage IE and IIE nasal natural killer/T-cell lymphoma were treated by definitive radiotherapy and chemotherapy. 33 patients were treated with chemotherapy followed by radiotherapy (CT + RT) and they received 50.4 Gy in 28 fractions. 13 patients were treated with concurrent chemoradiotherapy (CCRT) and they received 40 Gy in 20 fractions.
The median follow-up period was 4.6-137.6 months (median, 50.2 months) for all patients. The 4-year overall survival was 68.6% and 4-year disease free survival (DFS) was 61.9%. The 4-year locoregional recurrence free survival was 65.0%, and 4-year distant metastasis free survival (DMFS) was 66.2%. For patients treated with CT + RT, 15 patients (45.5%) achieved complete response after chemotherapy, and 13 patients (39.4%) achieved partial response. 13 patients (81.8%) achieved complete response after radiotherapy, and 6 patients (18.2%) achieved partial response. For patients treated with CCRT, 11 patients (84.6%) achieved complete response, and one patient (7.7%) achieved partial response. In univariate analysis, presence of cervical lymph node metastasis was only significant prognostic factor for DFS and DMFS.
This study did not show satisfactory overall survival rate and disease free survival rate of definitive radiotherapy and chemotherapy for stage IE and IIE nasal natural killer/T-cell lymphoma. For patients with cervical lymph node metastasis, further investigation of new chemotherapy regimens is necessary to reduce the distant metastasis.
评估IE期和IIE期鼻腔自然杀伤/T细胞淋巴瘤患者的放射治疗效果。
1999年8月至2009年8月，46例IE期和IIE期鼻腔自然杀伤/T细胞淋巴瘤患者接受了根治性放疗和化疗。33例患者先接受化疗再进行放疗（CT + RT），分28次给予50.4 Gy。13例患者接受同步放化疗（CCRT），分20次给予40 Gy。
所有患者的中位随访时间为4.6 - 137.6个月（中位值，50.2个月）。4年总生存率为68.6%，4年无病生存率（DFS）为61.9%。4年局部区域无复发生存率为65.0%，4年无远处转移生存率（DMFS）为66.2%。对于接受CT + RT治疗的患者，15例（45.5%）化疗后达到完全缓解，13例（39.4%）达到部分缓解。13例（81.8%）放疗后达到完全缓解，6例（18.2%）达到部分缓解。对于接受CCRT治疗的患者，11例（84.6%）达到完全缓解，1例（7.7%）达到部分缓解。单因素分析中，颈部淋巴结转移是DFS和DMFS的唯一显著预后因素。
本研究显示，对于IE期和IIE期鼻腔自然杀伤/T细胞淋巴瘤，根治性放疗和化疗的总生存率和无病生存率并不理想。对于有颈部淋巴结转移的患者，有必要进一步研究新的化疗方案以减少远处转移。
