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PVD方案联合调强放疗治疗早期结外鼻型NK/T细胞淋巴瘤的疗效

[Efficacy of PVD regimen combined with IMRT for early-stage extranodal nasal NK/T-cell lymphoma].

作者信息

Zhang Y, Huang Y H, Hu Y F, Liu Q L, Wu T

机构信息

Department of Lymphoma, Cancer Hospital of Guizhou Medical, Guiyang 550001, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Jul 11;97(26):2047-2049. doi: 10.3760/cma.j.issn.0376-2491.2017.26.007.

DOI:10.3760/cma.j.issn.0376-2491.2017.26.007
PMID:28763877
Abstract

To evaluate the efficacy of PVD chemo-regimen (Pegaspargase, vincristine and dexamethasone) combined with intensity-modulated radiotherapy (IMRT) for patients with early-stage extranodal nasal NK/T-cell lymphoma (ENKL). Clinical data of 52 patients with early-stage ENKL were collected during May 2010 and June 2015 in Department of Lymphoma, Cancer Hospital of Guizhou Medical University, and these patients firstly received a concurrent chemoradiotherapy of two-cycle of PVD and IMRT (gross tumor volume primary: 12.6-59.4 Gy) and then 2 to 4 cycles of PVD as subsequent chemotherapy, the efficacy and adverse responses were retrospectively analyzed and observed. Follow-up stopped until December 2015, complete remission was seen in 44 cases (84.6%) and partial remission 7 cases (13.5%), out of 52 cases. A total of 1 case died of progression disease during treatment and within 1 year after treatment, 1 case died of pulmonary infection within 1 week after treatment, 2 cases survived with tumor; so the objective response rate and clinical benefit rate were both 98.1%, 1-year, 2-year and 3-year overall survival rates and progression free survival rates were all 93.6%, 1-year and 2-year disease free survival rates were both 90.3%; the correlation analysis showed that the radiotherapy dose was related to the curative effect (<0.05). Short term adverse responses were observed in 6 cases (11.5%) with grade 3 leucocytopenia, in 5 cases (9.6%) with grade 3-4 dyslipidemia and in 2 cases (3.8%) with grade 3 hypoalbuminemia during chemoradiotherapy. All the patients had different degrees of radiation oral mucositis and radiation dermatitis. For early-stage ENKL, a concurrent chemoradiotherapy of PVD regimen and IMRT have a good therapeutic effect and adverse response can be tolerated.

摘要

评估聚乙二醇天冬酰胺酶、长春新碱和地塞米松(PVD)化疗方案联合调强放疗(IMRT)治疗早期结外鼻型NK/T细胞淋巴瘤(ENKL)患者的疗效。收集2010年5月至2015年6月期间贵州医科大学附属肿瘤医院淋巴瘤科52例早期ENKL患者的临床资料,这些患者首先接受两周期PVD与IMRT同步放化疗(大体肿瘤体积原发灶:12.6 - 59.4 Gy),然后接受2至4周期PVD作为后续化疗,对疗效及不良反应进行回顾性分析观察。随访至2015年12月,52例患者中,44例(84.6%)完全缓解,7例(13.5%)部分缓解。共有1例患者在治疗期间及治疗后1年内死于疾病进展,1例患者在治疗后1周内死于肺部感染,2例患者带瘤生存;客观缓解率和临床获益率均为98.1%,1年、2年和3年总生存率及无进展生存率均为93.6%,1年和2年无病生存率均为90.3%;相关性分析显示放疗剂量与疗效相关(<0.05)。放化疗期间,6例(11.5%)出现3级白细胞减少,5例(9.6%)出现3 - 4级血脂异常,2例(3.8%)出现3级低蛋白血症。所有患者均有不同程度的放射性口腔黏膜炎和放射性皮炎。对于早期ENKL,PVD方案联合IMRT同步放化疗具有良好的治疗效果,不良反应可耐受。

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