化疗与序贯放化疗治疗鼻型结外NK／T细胞淋巴瘤的疗效比较

目的：探讨化疗与序贯放化疗治疗鼻型结外NK／T细胞淋巴瘤的疗效。方法：57例经病理形态学及免疫组织化学检查确诊的鼻型结外NK／T细胞淋巴瘤患者，随机分为化疗组和放化疗组。化疗组23例患者交替应用CHOP方案、VDLP方案和MEOP方案各2个疗程后进人临床观察；放化疗组34例患者除上述化疗外，均应用直线加速器进行原发部位的三维适形放疗。结果：①治疗结束时，化疗组治疗总有效率为87．0％，放化疗组总有效率为91．2％，2组差异无统计学意义（P〉0．05）；②2组患者随访1年的总有效率分别为73．9％和76．5％，2组仍无明显差异（P〉0．05）；③2组患者随访3年和5年的无病生存率分别为61．3％，47．6％和43．5％，21．4％，差异均有统计学意义（P〈0．05）；④治疗模式与长期生存密切相关；⑤发热、消瘦、盗汗等全身症状、中晚期（Ⅲ、IV期）、国际预后指数、功能状态评分均与预后相关，且均为独立的预后因素。结论：序贯放化疗治疗鼻型结外NK／T细胞淋巴瘤较单纯化疗疗效明显，可以显著改善长期生存率。

Curative effect of nasal type extranodal NK/T-cell lymphoma by sequential chemotherapy combined radiotherapy compared with chemotherapy

Objective：To explore the curative effect of nasal type extranodal NK/T-cell lymphoma by sequen- tial chemotherapy combined radiotherapy compared with chemtherapy. Method： Fifty-seven cases of nasal type ex- tranodal NK/T-cell lymphoma confirmed by pathological morphology and immuno-histochemistry were divided into chemotherapy combined radiotherapy group（34 cases） or chemotherapy group（23 cases）. Twenty-three patients in the chemotherapy group alternately applied CHOP, VDLP and MEOP regimen after each two treatments into the clinical observation; Chemotherapy combined radiotherapy group of 34 patientsm, in addition to the above chemo- therapy, applied three-dimensional conformal radiation therapy of the primary site by linear accelerators. Then all of patients were ceased treatment and followed up 3--5 years. Result： ①After treatment, effective rate of two groups was 91.2 % and 87, 0 %, there was no obvious difference（P〉0.05） ;②After follow up about 1 year, effective rate of two groups was 76.5% and 73.9%, there was no obvious difference（P〉0.05） ;③After follow up a- bout 3 years and 5 years, disease free survival（DFS） of two groups was 61.3% ,47.6% and 43.5% ,21.4%, there was obvious difference（P〈0.05）. ④ Long-term survival is closely related to treatment mode. ⑤B symptoms, ad- vanced （Ⅲ , IV） stage, the International Prognostic Index（IPI）, KPS scores were correlated with prognosis, and were independent prognostic factors. Conclusion：Treatment with chemotherapy and radiotherapy for nasal type ex- tranodal NK/T-cell lymphoma had obvious curative effect and may improve long-term survival efficiently compared with chemothera!~v alone.