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69例结外自然杀伤T细胞淋巴瘤患者的临床特征与治疗

Clinical characteristics and treatment of 69 patients with extranodal natural killer T-cell lymphoma.

作者信息

Guo Yuyan, Li Enxiao, Song Liping, Wu Yinying

机构信息

Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan'xi 710061, P.R. China.

Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan'xi 710061, P.R. China.

出版信息

Mol Clin Oncol. 2016 Dec;5(6):750-756. doi: 10.3892/mco.2016.1067. Epub 2016 Oct 27.

Abstract

This study was conducted to retrospectively analyze the clinical characteristics and survival of patients with extranodal natural killer-T cell lymphoma (ENKL) and compare different treatment regimens. The univariate analysis demonstrated that survival was worse for patients with extranasal primary tumors, Eastern Cooperative Oncology Group performance status (ECOG PS) scores of ≥2, International Prognostic Index (IPI) scores of 3-5, Ann Arbor stage III and IV disease, B symptoms, lymph node involvement and absence of radiotherapy. The Cox analysis demonstrated that ECOG PS score, stage, IPI, presence of B symptoms and radiotherapy were independent prognostic factors for overall survival (OS). The effect of diverse therapies on survival was then analyzed, and it was found that the 5-year survival rate of patients receiving chemoradiotherapy differed significantly from that of patients who received chemotherapy alone [hazard ratio (HR)=0.347, P=0.0203], but did not differ significantly from the survival of patients treated with radiotherapy alone (HR=1.534, P=0.6371). A subgroup analysis revealed a difference between the radiotherapy and non-radiotherapy groups for patients with extranasal-type stage III/IV disease. It was concluded that ECOG score, stage, IPI, presence of B symptoms and radiotherapy were independent prognostic factors for OS in patients with ENKL. The addition of radiotherapy achieved better outcomes compared with chemotherapy alone, but no difference was observed between chemoradiotherapy and radiotherapy. Patients with advanced-stage disease may also benefit from radiotherapy.

摘要

本研究旨在回顾性分析结外自然杀伤T细胞淋巴瘤(ENKL)患者的临床特征及生存情况,并比较不同治疗方案。单因素分析表明,鼻外原发性肿瘤患者、东部肿瘤协作组体能状态(ECOG PS)评分≥2、国际预后指数(IPI)评分3 - 5、Ann Arbor分期III期和IV期疾病、B症状、淋巴结受累以及未接受放疗的患者生存情况较差。Cox分析表明,ECOG PS评分、分期、IPI、B症状的存在以及放疗是总生存(OS)的独立预后因素。随后分析了不同治疗方法对生存的影响,发现接受放化疗的患者5年生存率与单纯接受化疗的患者有显著差异[风险比(HR)=0.347,P = 0.0203],但与单纯接受放疗的患者生存率无显著差异(HR = 1.534,P = 0.6371)。亚组分析显示,鼻外型III/IV期疾病患者的放疗组与非放疗组之间存在差异。得出结论,ECOG评分、分期、IPI、B症状的存在以及放疗是ENKL患者OS的独立预后因素。与单纯化疗相比,加用放疗可取得更好的疗效,但放化疗与放疗之间未观察到差异。晚期疾病患者也可能从放疗中获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/972e/5228303/0e2b56d281c5/mco-05-06-0750-g00.jpg

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