韦氏环非霍奇金淋巴瘤综合治疗疗效及其预后因素分析

目的:探讨韦氏环非霍奇金淋巴瘤(NHL)综合治疗疗效及影响预后的因素.方法:回顾分析2001-07-2010-07收治的63例韦氏环NHL所有病例,用Kaplan-Meier计算其3、5年总生存率(OS)和无瘤生存率(DFS),Log-rank进行显著性检验,Cox模型进行单因素和多因素分析.结果:全组死亡20倒,3、5年OS分别为76.1％和64.4％.3、5年DFS分别为69.0％和61.6％.原发灶放射治疗剂量＜40、40～50 及＞50 Gy的5年OS分别为48.6％,73.7％和48.2％,x2=3.766,P=0.152.放疗前给予≥3个周期的化疗组及＜3个周期的化疗组5年OS分别为71.3％和58.5％·x2=0.797,P=0.372.多因素分析结果显示,近期疗效与国际预后指数(IPI)是独立预后因素.结论:对于韦氏环NHL患者宜采取综合治疗模式.近期疗效与IPI可作为韦氏环NHL临床预后的参考指标.

Outcome and prognostic factors in patients with Waldeyer's ring non-Hodgkin lymphoma

OBJECTIVE: To evaluate the outcome and prognostic factors in patients with Waldeyer’s ring non-Hodgkin lymphoma(NHL).METHODS: From July 2001 to July 2010,63 cases with Waldeyer’s ring NHL were treated by radiotherapy plus chemotherapy.Kaplan-Meier method was used for evaluating the overall survival rate and disease-free survival rate,Logrank method was used to evaluate the significance tests,Cox proportional hazard model was applied in univariate and multivariate analysis.RESULTS: The overall survival rate and disease-free survival rate at 3 and 5 years for all patients were 76.1%,64.4% and 69.0%,61.6%.The 5-year overall survival rate was 48.6% for radiotherapy dose below 40 Gy,73.7% for radiotherapy dose 40-50 Gy,48.2% for radiotherapy dose beyond 50 Gy(χ2=3.766,P=0.152).The 5-year overall survival rate was 71.3% for the patients with chemotherapy before radiotherapy beyond 3 times,58.5% for the patients with chemotherapy before radiotherapy below 3 times(χ2=0.797,P=0.372).Multivariate analysis by Cox model showed that complete response to the combined modality therapy and international prognostic index(IPI) were independent prognostic factors related to long-term survival.CONCLUSIONS: The combined radiotherapy and chemotherapy should be applied in Waldeyer’s ring NHL,especially in early stage.Complete response to the combined modality therapy and IPI are independent prognostic factors.