早期鼻腔NK/T细胞淋巴瘤治疗方法和预后分析

目的 探讨不同治疗方法对早期鼻腔NK/T细胞淋巴瘤预后的影响.方法 回顾分析15年问85例ⅠE、ⅡE期鼻腔NK/T淋巴瘤放疗及CHOP为主化疗的疗效.单纯化疗(单化组)20例,放疗后±化疗(放化组)17例(单纯放疗11例),化疗后放疗(化放组)48例.生存率计算采用Kaplan-Meier法,并Logrank法检验,Cox回归模型进行多因素分析.结果 全组5年生存率为40%,单化纽、放化组和化放组的分别为13%、54%和47%,放化纽和化放组均优于单化组(P=0.030和0.049).ⅠE局限组与超腔组的5年生存率分别为57%与28%(χ2=8.87,P=0.003),ⅡE期的为23%,与ⅠE超腔组相似(χ2=0.19,P=0.664).近期疗效达到完全缓解与未完全缓解的5年生存率分别为58%与12%(χ2=30.68,P=0.000).放疗剂量≤50 Gy与>50 Gy的完全缓解率分别为56%和86%(χ2=6.11,P=0.013),5年无复发生存率分别为89%与84%(χ2=0.36,P=0.551).首程化疗的68例中≤2、3～4、≥5个疗程者分别为18、20、30例,完全缓解率分别为0%、20%、33%(χ2=7.65,P=0.022).首程先化疗且≥3个疗程的50例和先放疗≥40 Gy的17例的完全缓解率分别为28%和88%(χ2=18.75,P=0.000).结节型和溃疡型的完全缓解率放疗均优于化疗(100%:38%,2X=7.92,P=0.005和100%:11%,χ2=14.40,P=0.000).多因素分析显示临床分期和近期疗效是影响预后的独立因素.结论 早期鼻腔NK/T细胞淋巴瘤首程应选择50 Gy放疗为宜.对于ⅠE期超腔与ⅡE期应酌情联合化疗,但CHOP方案效果欠佳.     

早期鼻腔NK/T细胞淋巴瘤治疗方法和预后分析

Objective To investigate the prognosis of patients with nasal NK/T cell lymphoma receiving different treatment modalities. Methods From 1990 to 2004, 85 patients with stage ⅠE and ⅡE primary nasal NK/T cell lymphomas were retrospectively studied. Twenty patients received chemotherapy of CHOP regimen alone, 11 patients received radiotherapy only, 6 patients received radiotherapy followed by more than 2 cycles of chemotherapy, and 48 patients received more than 2 cycles of chemotherapy followed by radiotherapy. Survival analysis was performed by the Kaplan-Meier method, the difference between groups was evaluated by the Log-rank test, and the Cox regression model was used for multivariate analysis. Results The 5-year overall survival rate (OS) was 40%. The 5-year OS was 57% and 28% for limited stage ⅠE and extended stage ⅠE(X2 =8. 87, P =0. 003), and 23% for stage ⅡE, which was similar to extended stage ⅠE (X2 =0. 19, P-0. 664). The 5-year OS was 13%, 54% and 47% for chemotherapy alone, radiotherapy followed with or without chemotherapy, and chemotherapy followed by radiotherapy, respectively. The last two groups had better OS than chemotherapy alone (P = 0. 030 and 0.049). The 5-year OS was 58% and 12% for patients achieving complete response (CR) and uncomplete response (X2 = 30.68, P = 0. 000).The CR rate was 56% and 86% for radiotherapy of ≤50 Gy and >50 Gy (X2 =6.11, P=0. 013). The corresponding 5-year relapse-free survival rate was 89% and 84% (X2 =0.36, P=0.551). Of 68 patients receiving initial chemotherapy, the CR rate of those who received ≤2, 3-4 and ≥5 cycles was 0, 20%and 3 3 % , respectively (X2 = 7.65 , P = 0. 022) . For 5 0 patients who received ≥ 3 cycles of initial chemotherapy and 17 patients who received initial radiotherapy of ≥40 Gy, the CR rate was 28% and 88%(χ2= 18. 75, P= 0. 000). In patients with pathological nodular and ulcer type, the CR rates with radiotherapy were higher than with chemotherapy (100%: 38%, χ2 = 7.92, P = 0. 005; and 100%: 11%,χ2 = 14.40, P = 0. 000). Multivariate analysis showed that stage and recent effect were the independent prognostic factors. Conclusions The initial radiotherapy with 50 Gy is appropriate for early stage nasal NK/T cell lymphomas. Combined chemotherapy could be used for extended stage ⅠE and ⅡE, but the outcome of CHOP regimen is poor.     

早期鼻腔NK/T细胞淋巴瘤治疗方法和预后分析

Objective To investigate the prognosis of patients with nasal NK/T cell lymphoma receiving different treatment modalities. Methods From 1990 to 2004, 85 patients with stage ⅠE and ⅡE primary nasal NK/T cell lymphomas were retrospectively studied. Twenty patients received chemotherapy of CHOP regimen alone, 11 patients received radiotherapy only, 6 patients received radiotherapy followed by more than 2 cycles of chemotherapy, and 48 patients received more than 2 cycles of chemotherapy followed by radiotherapy. Survival analysis was performed by the Kaplan-Meier method, the difference between groups was evaluated by the Log-rank test, and the Cox regression model was used for multivariate analysis. Results The 5-year overall survival rate (OS) was 40%. The 5-year OS was 57% and 28% for limited stage ⅠE and extended stage ⅠE(X2 =8. 87, P =0. 003), and 23% for stage ⅡE, which was similar to extended stage ⅠE (X2 =0. 19, P-0. 664). The 5-year OS was 13%, 54% and 47% for chemotherapy alone, radiotherapy followed with or without chemotherapy, and chemotherapy followed by radiotherapy, respectively. The last two groups had better OS than chemotherapy alone (P = 0. 030 and 0.049). The 5-year OS was 58% and 12% for patients achieving complete response (CR) and uncomplete response (X2 = 30.68, P = 0. 000).The CR rate was 56% and 86% for radiotherapy of ≤50 Gy and >50 Gy (X2 =6.11, P=0. 013). The corresponding 5-year relapse-free survival rate was 89% and 84% (X2 =0.36, P=0.551). Of 68 patients receiving initial chemotherapy, the CR rate of those who received ≤2, 3-4 and ≥5 cycles was 0, 20%and 3 3 % , respectively (X2 = 7.65 , P = 0. 022) . For 5 0 patients who received ≥ 3 cycles of initial chemotherapy and 17 patients who received initial radiotherapy of ≥40 Gy, the CR rate was 28% and 88%(χ2= 18. 75, P= 0. 000). In patients with pathological nodular and ulcer type, the CR rates with radiotherapy were higher than with chemotherapy (100%: 38%, χ2 = 7.92, P = 0. 005; and 100%: 11%,χ2 = 14.40, P = 0. 000). Multivariate analysis showed that stage and recent effect were the independent prognostic factors. Conclusions The initial radiotherapy with 50 Gy is appropriate for early stage nasal NK/T cell lymphomas. Combined chemotherapy could be used for extended stage ⅠE and ⅡE, but the outcome of CHOP regimen is poor.     

早期NK/T细胞淋巴瘤扩大受累野IMRT结果

目的 评价早期NK/T细胞淋巴瘤使用扩大受累野IMRT结果,分析临床特征和治疗因素对于预后的影响。 方法 回顾分析2007—2016年间 165例早期NK/T细胞淋巴瘤接受扩大受累野IMRT,158例(95.8%)采用放化疗,7例(4.2%)单纯放疗。140例(84.8%)原发部位放疗剂量≥50 Gy,25例(15.2%)<50 Gy。147例(89.1%)接受门冬酰胺酶为主方案化疗,仅 11例(6.7%)接受CHOP或CHOP类方案化疗。109例(66.1%)接受≥4周期化疗。Kaplan-Meier法计算LRC、OS、PFS率,Logrank法检验和单因素预后分析,Cox模型多因素预后分析。 结果 5年样本量 55例,5年OS、PFS、LRC率分别为74.2%、72.5%、84.4%。放疗≥50 Gy显著提高了LC率,5年LRC为91.8%,而<50 Gy仅为39.7%(P=0.000)。早期低危组 5年OS为94.2%,而早期高危组仅为68.1%(P=0.002)。早期高危NK/T细胞淋巴瘤联合≥4个周期化疗较<4个周期组显著改善生存率,5年OS分别为71.3%和59.5%(P=0.032);5年PFS分别为70.4%和54.4%(P=0.009)。多因素分析显示ECOG≥2(P=0.006)、原发肿瘤侵犯(P=0.002)、Ann Arbor分期Ⅱ期(P=0.014)是OS影响因素,ECOG≥2(P=0.004)、原发肿瘤侵犯(P=0.016)是LRC的影响因素,而ECOG≥2(P=0.045)、原发肿瘤侵犯(P=0.003)、Ann Arbor分期Ⅱ期(P=0.030)、原发于鼻腔外(P=0.032)是PFS的影响因素。 结论 ≥50 Gy扩大受累野的IMRT对于早期NK/T细胞淋巴瘤有良好的LRC、OS和PFS。对于预后不良组的早期NK/T细胞淋巴瘤远处失败较高,放疗联合≥4周期化疗能显著改善OS和PFS。     

培门冬酶联合调强适形放疗治疗早期鼻腔NK／T细胞淋巴瘤20例效果观察

目的：观察培门冬酶联合调强适形放疗（IMRT）治疗Ⅰ～Ⅱ期鼻腔NK／T细胞淋巴瘤的效果及患者不良反应。方法回顾性分析2011年1月至2013年9月20例原发鼻腔NK／T细胞淋巴瘤患者的临床资料,其中,男性14例,女性6例;中位年龄41岁（16～66岁）。采用以培门冬酶为主的POD方案化疗联合IMRT。结果20例患者完全缓解10例,部分缓解7例,稳定1例,进展2例。不良反应多为Ⅰ～Ⅱ度,可耐受。结论培门冬酶联合IMRT同步治疗Ⅰ～Ⅱ期鼻腔NK／T细胞淋巴瘤疗效好,不良反应轻。     

Ⅰ～Ⅱ期鼻腔结外NK/T细胞淋巴瘤放射治疗疗效分析

目的:探讨Ⅰ～Ⅱ期鼻型结外NK/T细胞淋巴瘤根治性放疗的方法以及以放疗为主的综合治疗的疗效。方法:2005年9月—2009年4月连续收治的193例经病理学证实的、原发灶位于上呼吸道的Ⅰ～Ⅱ期结外NK/T细胞淋巴瘤患者,行根治性放疗,总剂量为50Gy/25次,联合或不联合以CEOP或DICE方案为主的诱导化疗。放疗范围为区域野。放疗技术采用三维适形或调强放疗。观察治疗反应率、局部和区域复发率以及生存情况。结果:全组患者的3年生存率为73.7%,3年无进展生存率为66.4%。24例接受单纯放疗患者的完全缓解率为100%。放化疗组有169例患者,其中4例因化疗中出现疾病进展而未行放疗,剩余165例接受放疗的患者中有147例达CR。3年局部控制率为90.3%。41例患者发生远处转移。多因素分析显示,原发灶累及范围与3年无进展生存期以及野内/边缘复发相关。结论:目前区域野的Ⅰ～Ⅱ期鼻型结外NK/T细胞淋巴瘤的肿瘤放疗剂量50Gy可以获得较好的反应率和较低的局部复发率。今后需要设计更有效的化疗方案以减少远处转移。     

早期鼻腔NK/T细胞淋巴瘤局部侵犯特点和靶区定义

目的 分析早期鼻腔NK/T细胞淋巴瘤病例影像学上各个解剖部位受侵概率,为临床靶区设计提供依据.方法 回顾分析1987-2009年经病理证实的222例Ⅰ E、Ⅱ E期鼻腔NK/T细胞淋巴瘤.以影像学为标准,明确邻近受侵器官和结构数目以及淋巴结转移情况.结果 222例患者中64%患者原发肿瘤累及至少一个或多个邻近器官或结构.将鼻腔周围结构依据受侵概率高低分为高危受侵区域(≥40%):筛窦(60%)和上颌窦(55%);中危受侵区域(5%～40%):鼻咽(39%)、鼻背皮肤(22%)、口咽(12%)、眼眶(10%)和硬腭(10%);低危受侵区域(≤5%):蝶窦(3%)、额窦(3%)、软腭(3%)和颅底(1%).全组病例颈部淋巴结转移率为16%(36例).33例Ⅱ E期患者因有影像检查可明确分析颈部淋巴结转移部位,其中最常见受侵区域为颌下或颏下(57%)和上颈部淋巴结(57%).肿瘤局限于一侧鼻腔,对侧颈部淋巴结转移占全部颈淋巴结转移病例(33例)的54%;肿瘤侵犯双侧鼻腔,55%的病例有双侧颈部淋巴结转移.88例超腔Ⅰ期病例未行颈部淋巴结预防照射,颈部淋巴结失败率仅为1%.Ⅰ E期同时合并韦氏环如鼻咽(23例)和口咽(7例)受侵病例,未行颈部淋巴结预防照射,未出现颈部淋巴结失败病例.结论 早期鼻腔NK/T细胞淋巴瘤放疗时应将周围高危解剖结构纳入临床靶区范围,并依据个体侵犯特点考虑中危区域及低危区域的纳入;对颈部淋巴结处理,Ⅰ E期不行颈部预防照射,Ⅱ E期推荐行双侧全颈部照射.

Abstract：

Objective To define the patterns of local extension and nodal involvement in patients with early stage nasal NK/T-cell lymphoma, and to improve the delineation of clinical target volume.Methods Two hundred and twenty-two patients consecutively diagnosed with nasal NK/T-cell lymphoma were reviewed.All patients had stage Ⅰ E/Ⅱ E diseases.CT/MRI images were reviewed to determine the local invasion of adjacent organs or structures and involvement of lymph node.Results 143 of 222(64%) patients had primary tumor extended into adjacent organs or structures from nasal cavity.According to the incidence rates of tumor extension, the involved organs or structures were subclassified into three subgroups:high risk (≥40%):ethmoid sinus (60%) and maxillary sinus (55%);intermediate risk (5%-40%):nasopharynx (39%), skin (22%), oropharynx (12%), orbit (10%), and hard palate (10%);and low risk (≤5%):sphenoid sinus (3%), soft plate (3%),frontal sinus (3%) and skull base (1%).Cervical lymph node metastasis occurred in 16%(36/222) of the patients and these patients were staged as Ⅱ E.Thirty-three patients with stage Ⅱ E disease had available images and were analyzed for the pattern of nodal involvement.Submandibular or submental (57%) and the upper cervical lymph nodes (57%) were the most commonly involved sites of nodal region.For the 24 patients with primary tumor located in the unilateral nasal cavity, 54% presented with contralateral cervical lymph node metastasis.Whereas for the 9 patients with primary tumor located in the bilateral nasal cavity, 57% had bilateral cervical lymph node metastasis.For the 88 patients with extensive stage Ⅰ E disease who did not receive irradiation to the cervical lymph node, only one patient (1%) had disease relapse in cervical lymph node.Furthermore, all patients with disease extended to nasopharynx (n= 23) or oropharynx (n= 8) did not receive prophylactic cervical lymph node irradiation, and none of them developed cervical lymph node relapse.Conclusions The delineation of clinical target volume for early stage nasal NK/T-cell lymphoma should be determined by the risk of involvement of paranasal structures and cervical lymph node.Prophylactic neck irradiation is not recommended for patients with stage Ⅰ disease.     

早期原发鼻腔与韦氏环NK/T细胞淋巴瘤临床特征和预后比较

目的 探讨Ⅰ_E~Ⅱ_E期原发鼻腔与原发韦氏环NK/T细胞淋巴瘤在临床特征和预后等方面的差别。方法 回顾分析1991-2011年本院初治的273例患者,其中Ⅰ_E期184例,Ⅱ_E期89例。原发鼻腔(NC-NKTL)209例和原发韦氏环(WR-NKTL)64例。258例(94.5%)患者先接受化疗,多数患者接受CHOP或类似方案化疗,放疗中位剂量为54 Gy。结果 与NC-NKTL相比,WR-NKTL中Ⅱ_E期和有B症状者显著增多。两组治疗后有效率相近(88.7%和87.9%,P=0.869)。随访率96.3%,随访时间满5年者196例。5年总生存率(OS)和无进展生存率(PFS)分别为52.6%和41.4%,其中NC-NKTL的5年OS有高于WR-NKTL的趋势(57.0%∶39.0%,P=0.062),而5年PFS则高于WR-NKTL的(46.7%∶25.8%,P=0.019)。结论 早期原发韦氏环NK/T细胞淋巴瘤较原发鼻腔病变更易发生全身症状和颈部淋巴结转移,预后较差,临床上考虑提早放疗和颈部淋巴结预防照射。     

130例鼻腔和韦氏环NK/T细胞淋巴瘤放化疗预后分析

目的 观察鼻腔、韦氏环NK/T细胞淋巴瘤放化疗疗效,并分析影响预后的因素。
方法2000-2010年本院共收治经免疫组化确诊130例鼻腔、韦氏环NK/T细胞淋巴瘤,其中鼻腔的109例、韦氏环的21例。Ann Arbor分期Ⅰ_E期116例、Ⅱ_E期14例。单纯放疗30例,单纯化疗2例,放化疗联合98例。
结果 随访率100%,随访时间满5年者78例。完全缓解率全组为89.2%,Ⅰ_E、Ⅱ_E期的分别为88.8%、92.9%(χ²=0.02,P=0.837),单纯放疗、放化疗联合的分别为86%、96%(χ²=1.44,P=0.230)。全组5年总生存(OS)和无瘤生存(DFS)率分别为58.0%和57.2%,Ⅰ_E、Ⅱ_E期患者5年OS分别为60.6%、36.3%(χ²=0.25,P=0.615),5年DFS分别为59.7%、36.3%(χ²=0.21,P=0.648);单纯放疗、放化联合的5年OS分别为70%、48%(χ²=0.01,P=0.933),5年DFS分别为66%和48%(χ²=0.09,P=0.764)。单纯放疗、放化联合的主要3、4级不良反应总发生率分别为6.7%、54.1%(χ²=41.38,P=0.002)。原发灶照射剂量(χ²=3.18,P=0.005)、ECOG评分(χ²=2.97,P=0.008)与OS相关。
结论 Ⅰ_E、Ⅱ_E期鼻腔、韦氏环NK/T细胞淋巴瘤放化联合与单纯放疗疗效相似,但不良反应较重;原发灶照射剂量、ECOG评分是影响OS的因素。     

鼻腔NK/T细胞淋巴瘤螺旋断层治疗与常规加速器调强放疗的剂量学研究

目的分析评价鼻腔NK/T细胞淋巴瘤在螺旋断层放疗（helical tomotherapy,HT）与常规静态调强放疗（IMRT）2种治疗技术中剂量学特点。方法对10例局限性Ⅰ～Ⅱ期鼻腔NK/T细胞淋巴瘤患者,统一给予靶区剂量50Gy/25次,对每例患者分别实施设计HT和IMRT计划。比较靶区、危及器官剂量分布情况。结果 HT组平均适形度指数为0.81,平均均匀性指数为1.08,均明显好于IMRT组（平均适形度指数为0.71,平均均匀性指数为1.12）（t=8.22,t=-4.81,P〈0.05）。HT组晶体、腮腺和脑干的最大剂量与平均剂量均小于IMRT组,HT组腮腺的V5、V10和V15低于IMRT组,而HT组视神经的最大剂量、平均剂量、V20、V30和V40均高于IMRT组,但无统计学意义。结论 HT和IMRT计划均有较好的靶区剂量分布,但HT技术较IMRT技术明显改善了靶区剂量分布适形度,降低了晶体等正常组织受照剂量,可使患者从中获益,其临床意义有待进一步研究。     

Treatment outcome of angiocentric T-cell and NK/T-cell lymphoma, nasal type: radiotherapy versus chemoradiotherapy

OBJECTIVE: The purpose of this study was to evaluate the treatment outcome of angiocentric T-cell and natural killer (NK)/T-cell lymphoma, nasal type. METHODS: Between February 1989 and March 2001, 53 patients with newly diagnosed angiocentric T-cell and NK/T-cell lymphoma, nasal type involving the head and neck, were treated with radiation therapy (RT). There were 37 males and 16 females. The median age of the patients was 45 years (range 19-73). Twenty of them were treated with chemoradiotherapy (CRT), while 33 with treated with RT alone. The median follow-up period was 74 months (range 6-173). RESULTS: The 5-year overall survival rate of all patients was 69%. CRT appeared to be inferior to RT alone in terms of 5-year overall survival, though the difference was not statistically significant (59 versus 76%, P = 0.27). CONCLUSIONS: There was no difference in survival between RT and CRT in angiocentric T-cell and NK/T-cell lymphoma, nasal type.     

P-Gemox方案联合调强放疗治疗早期结外NK/T细胞淋巴瘤的临床疗效

目的 探讨P-Gemox方案联合调强放疗治疗早期结外NK/T细胞淋巴瘤（extranodal NK/T-cell lymphoma,ENKTL）的疗效。方法 回顾性分析四川省肿瘤医院2012年3月至2017年10月初治的73例ENKTL患者的临床资料,根据治疗方案分为P-Gemox方案夹心放疗组（n=38）和P-Gemox方案序贯放疗组（n=35）,比较两组患者的近期和远期临床疗效。结果 73例ENKTL患者总有效率（ORR）为95.9%,3年无进展生存率（PFS）为73.5%,3年总生存率（OS）为81.9%。P-Gemox方案夹心放疗组ORR为97.4%,3年PFS和OS分别为74.2%和84.1%。P-Gemox方案序贯放疗组ORR为94.3%,3年PFS和OS分别为72.6%和79.2%。两组ORR、PFS和OS差异均无统计学意义（P＞0.05）。控制相关潜在混杂因素后,多因素Cox回归分析显示,P-Gemox方案夹心放疗组与P-Gemox方案序贯放疗组的PFS相当（HR=0.617,95%CI：0.353~1.081,P=0.091）,而P-Gemox方案夹心放疗组较P-Gemox方案序贯放疗组OS更好 （HR=0.556,95%CI：0.314~0.982,P=0.043）。两组化疗毒副反应以Ⅰ～Ⅱ级为主,其中P-Gemox方案夹心放疗组较P-Gemox方案序贯放疗组更容易发生Ⅰ～Ⅱ度转氨酶升高（P＜0.05）,血液学、胃肠道等毒副反应,发生率差异无统计学意义（P＞0.05）。结论 P-Gemox方案夹心放疗与P-Gemox方案序贯放疗的近期疗效和PFS相当,但P-Gemox方案夹心放疗较P-Gemox方案序贯放疗可提高患者OS。     

鼻腔自然杀伤/T细胞淋巴瘤放射治疗的疗效和影响因素

 目的　回顾分析鼻腔自然杀伤（NK）／T细胞淋巴瘤的放射治疗效果,并分析其预后因素。方法　回顾分析9年间接受放射治疗的62例鼻腔NK／T细胞淋巴瘤的临床资料和疗效,单因素分析采用Kaplan-Meier法,多因素分析用COX比例风险模型。结果　全组中位生存时间69.7个月（95 % CI为63.0～78.0个月）,3、5年总生存率分别为66.1 %和46.8 %,远处转移导致治疗失败占61.8 %。T淋巴细胞CD3升高组和降低组的中位生存时间分别为72.6个月和39.6个月,两组比较差异有统计学意义（χ2＝4.9309,P＝0.0264）。多因素分析表明,修正后国际预后指数（IPI）为0～1（χ2＝7.5266,P＝0.0061）、CD3升高（χ2＝9.0912,P＝0.0266）和治疗结束达到CR（χ2＝9.0912,P＝0.0106）是影响鼻腔NK／T细胞淋巴瘤放疗总生存的有利预后因素。结论　放射治疗鼻腔NK／T细胞淋巴瘤疗效肯定,但远处转移治疗失败率高,全身治疗仍具有重要地位;修正后IPI为0～1、CD3升高、治疗结束达到CR是影响鼻腔NK／T细胞淋巴瘤放疗总生存的有利预后因素。     

Radiotherapy combined with chemotherapy versus radiotherapy alone for early stage nasal natural killer/T-cell lymphoma: a meta-analysis

Objective: To compare the efficacy of radiotherapy (RT) plus chemotherapy (CMT) versus RT alone for early stage nasal natural killer (NK)/T-cell lymphoma.

Methods: All the eligible studies were searched by PubMed, Medline, Embase and the Cochrane Library. The meta-analysis was performed to compare odds ratios (ORs) for overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS).

Results: Eight studies were included in the meta-analysis. Chemotherapy group did not significantly differ from RT group. The pooled OR and 95% confidence interval (CI) for 1-year, 3-year, 5-year and 10-year OS was 1.25 [0.84, 1.87], 1.10 [0.76, 1.58], 0.83 [0.59, 1.17] and 1.05 [0.70, 1.56]. In addition, the combined OR and 95% CI for 5-year DFS and PFS were 0.96 [0.53, 1.73] and 0.71 [0.45, 1.12].

Conclusions: The current evidence suggests that CMT was not superior to RT alone. Radiotherapy may be still the main method in the treatment of early stage nasal NK/T-cell lymphoma.     

不同治疗方案对鼻、鼻型NK/T细胞淋巴瘤疗效分析

目的：探讨鼻、鼻型NK/T细胞淋巴瘤的临床特征、治疗方法和预后。方法：收集自2004年1月-2010年1月在我院住院治疗的29例鼻、鼻型NK/T细胞淋巴瘤患者临床资料,分析其临床特点、治疗方案及预后。结果：治疗分CHOP方案组及L-ASP组,总有效率分别为56.3%和75.9%（P=0.045）。两组5年OS率和DFS率分别为43.75%、61.54%（P=0.038）及18.8%、46.15%（P=0.009）,具有统计学意义。难治组7例经VDLP方案补救化疗后总有效率为71.3%。B组症状、临床分期及KPS评分可能对患者的生存产生影响。结论：对于临床早期的鼻、鼻腔NK/T细胞淋巴瘤患者,初治时可以选择CHOP方案治疗,而中、晚期病例及CHOP方案治疗无效的病例,选择以左旋门冬酰胺酶为主的联合化疗结合放疗综合治疗可取得较好疗效。     

不同治疗方案对鼻、鼻型NK/T细胞淋巴瘤疗效分析

目的 探讨鼻、鼻型NK/T细胞淋巴瘤的临床特征、治疗方法和预后.方法 收集自2004年1月-2010年1月在我院住院治疗的29例鼻、鼻型NK/T细胞淋巴瘤患者临床资料,分析其临床特点、治疗方案及预后.结果:治疗分CHOP方案组及L-ASP组,总有效率分别为56.3%和75.9%（P=0.045）.两组5年OS率和DFS率分别为43.75%、61.54%（P=0.038）及18.8%、46.15%（P=0.009）,具有统计学意义.难治组7例经VDLP方案补救化疗后总有效率为71.3%.B组症状、临床分期及KPS评分可能对患者的生存产生影响.结论:对于临床早期的鼻、鼻腔NK/T细胞淋巴瘤患者,初治时可以选择CHOP方案治疗,而中、晚期病例及CHOP方案治疗无效的病例,选择以左旋门冬酰胺酶为主的联合化疗结合放疗综合治疗可取得较好疗效.