嗅神经母细胞瘤的治疗与预后探讨

为分析嗅神经母细胞瘤(esthesioneuroblastoma ENB)的临床特点,并探讨其预后因素及治疗方法,回顾性分析1995年7月～2006年8月10例经病理确诊的ENB患者,改良Kadish分期示A期1例,B期5例,C期2例,D期2例。单纯手术治疗3例,单纯放射治疗1例,综合治疗6例(手术 放射治疗4例,手术 放射治疗 化疗2例)。全组5年生存率(OS)和5年无瘤生存率(DFS)分别为71.4%和62.5%,KadishA/B期和C/D期的5年OS分别为100.0%和33.3%(χ2=3.28,P=0.07),有颈部淋巴结和无颈部淋巴结转移者的5年DFS分别为0和83.3%(χ2=8.33,P=0.004),综合治疗(≥2种治疗方式)与单纯手术加单纯放疗的5年OS为80.0%和50.0%,5年DFS为80.0%和33.3%(χ2=1.06,P=0.30)。初步研究结果提示,随着诊断技术的提高,ENB的报道较前增多;该病的预后与Kadish分期及颈部淋巴结是否转移相关,治疗上,以包括手术的综合治疗为主,放射治疗在该病的治疗中占有重要地位。     

嗅神经母细胞瘤诊断与治疗的临床分析

目的探讨鼻腔嗅神经母细胞瘤的诊断治疗方法及预后的相关因素。方法回顾性分析我院1994年1月-2010年5月收治的嗅神经母细胞瘤12例,改良Kadish分期A期1例,B期5例,C期3例,D期3期。含手术的综合治疗6例,单独手术4例,单独放疗1例,单独化疗1例。结果全组患者5年总生存率（OS）为90.9%,5年无病生存率（DFS）为74.1%。A、B期和C、D期患者的5年OS分别为100%和80.0%（χ²=1.20,P=0.27）,5年DFS分别为100%和44.4%（χ²=4.07,P=0.04）。有淋巴结转移和无淋巴结转移患者的5年OS分别为66.7%和100%（χ²=2.67,P=0.10）,5年DFS分别为33.3%和87.5%（χ2=4.88,P=0.03）。综合治疗与单一治疗的5年OS分别为100%和80.0%（χ²=1.20,P=0.27）,5年DFS分别为83.3%和62.5%（χ2=0.35,P=0.88）。结论嗅神经母细胞瘤的早期诊断较难,该病的治疗以综合治疗疗效较好,放疗是该病重要的治疗手段,该病预后与疾病分期及淋巴结转移情况相关。     

129例原发鼻腔非霍奇金淋巴瘤的预后分析

背景与目的：原发鼻腔非霍奇金淋巴瘤（non-Hodgkin’s lymphoma,NHL）预后较差．远处转移和局部复发率均较高．目前本病尚无标准治疗原则。本研究主要探讨影响原发鼻腔NHL的预后因素。方法：1996年1月至2002年12月共收治129例经病理证实的原发鼻腔NHL。116例经病理形态学诊断为鼻腔NK／T细胞淋巴瘤。根据Ann Arbor分期,ⅠE期102例,ⅡE期22例,ⅣE期5例。124例ⅠE／ⅡE期患者单纯放疗22例,单纯化疗7例,45例放疗后化疗,50例化疗后放疗。5例ⅣE期以化疗为主。结果：全组5年总生存率（overall survival,OS）和无病生存率（disease-freely survival,DFS）分别是68．0％和55．8％。ⅠE期和ⅡE期患者的5年OS分别是71．7％和70．6％（P=0．77）,DFS分别是60．9％和47．0％（P=0．09）。首程治疗后完全缓解（complete response,CR）的患者5年OS为83．1％,而未达CR患者的5年OS为18．0％（P〈0．01）,相应5年DFS分别为68．0％和15．5％（P〈0．01）。国际预后指数（international prognostic index,IPl）评分为0,1和≥2的5年OS分别为81．1％、60．1％和14．3％（P〈0．01）,DFS分别为68．8％、44．6％和22．5％（P〈0．01）。38例患者治疗中进展或疗后复发,远处结外器官复发占78．9％,是治疗失败主要原因。单因素分析显示,首程治疗后的CR率、一般状态评分（performance status,PS）、IPI和修订后IPI与预后相关。多因素分析显示仅治疗后的CR率是独立预后因素。结论：治疗后的CR率是影响原发鼻腔NHL的重要预后因素,原因以远处病灶治疗失败为主。     

原发鼻腔非霍奇金淋巴瘤的治疗选择和疗效

目的 分析原发鼻腔非霍奇金淋巴瘤（NHL）放疗和化疗的近期疗效以及治疗方法对预后的影响。方法 129例经病理证实的原发鼻腔NHL患者中,经形态学诊断为鼻腔NK／T细胞淋巴瘤者116例。做免疫组化57例,其中52例为NK／T细胞来源,占91．2％;5例为B细胞来源,占8．8％。根据Ann Arbor分期,ⅠE期102例,ⅡE期22例,ⅣE期5例,ⅠE和ⅡE期患者中,单纯放疗22例,单纯化疗7例,综合治疗95例,ⅣE期以化疗为主。结果 5年总生存率（OS）和无病生存率（DFS）分别为68．0％和55．8％,ⅠE期和ⅡE期患者的5年OS分别为71．7％和70．6％（P=0．77）,DFS分别为60．9％和47．0％（P=0．09）。首程治疗后达CR患者的5年OS为83．1％,而未达CR患者的5年OS为18．0％（P=0．000）,相应5年DFS分别为68．0％和15．5％（P=0．000）。124例ⅠE和ⅡE期患者中,67例患者接受单纯放疗或放疗后化疗,放疗后完全缓解率（CR）为74．7％,其余57例为化疗后放疗或单纯化疗,化疗后CR率仅19．3％（P=0．000）,46例化疗后未达CR的患者中,42例仍局限于局部区域,31例经放疗达到CR,ⅠE和ⅡE期患者中,先放疗组（放疗＋化疗或单纯放疗）、化疗后放疗组的5年OS分别为76．0％和74．4％,DFS分别为65．0％和56．2％（P〉0．05）,ⅠE和ⅡE期单纯化疗7例,3例存活,4例死亡,中位生存时间15个月,1年生存率为26．7％。结论 中国人原发鼻腔NHL主要为NK／T细胞来源,放疗的近期疗效显著优于化疗,化疗加入放疗并未改善生存率,ⅠE和ⅡE期患者应以放射治疗为主要治疗手段。     

不同手术方式联合放射治疗Kadish B或Kadish C期嗅神经母细胞瘤的疗效分析

目的 评估不同手术方式联合放射治疗嗅神经母细胞瘤的疗效。方法 回顾分析1979—2014年我院收治的53例接受手术联合放疗的局部晚期嗅神经母细胞瘤疗效,对比不同手术方式肿瘤残存率及治疗效果。组间比较行卡方检验,Kaplan-Meier法计算生存率并Logrank法检验。结果 全组随访时间中位数为71个月,5年OS、DFS率分别为86%、74%。全组患者按手术方式分为开放手术组31例、内镜手术组 22例,内镜手术组肿瘤残存率高于开放手术组(分别为64%、42%,P=0.166)。Kadish C期者内镜手术肿瘤残存率达78%。肿瘤完全切除者5年OS、DFS率分别为91%、80%,肿瘤残存者分别为82%、67%。内镜手术组与开放手术组5年OS、DFS率相近[83%与86%(P=0.560)、77%与71%(P=0.188)]。内镜手术组中更多患者接受术后放疗剂量>66 Gy (P=0.011),而术后接受放疗剂量>66 Gy者和≤66 Gy者的5年OS、DFS率分别为100%和67%(P=0.092)、100%和50%(P=0.052)。结论 手术联合放疗用于改良Kadish B、KadishC期嗅神经母细胞瘤可取得较好的治疗疗效。内镜手术应严格掌握指征,目前对Kadish C期或额窦受侵者不主张行内镜手术。对手术切缘状态无法保证者,术后放疗剂量建议>66 Gy。     

60例原发灶不明的颈转移性鳞癌的放射治疗

目的：探讨颈淋巴结的临床分期和不同大小的放射治疗野对原发灶不明的颈转移性鳞癌的预后影响。方法：回顾性分析本院1989年1月至1997年12月间收治的60例原发灶不明的预转移性鳞癌（不包括锁骨上区转移者）的临床资料。结果：全组病例5年总的生存率为68．5％,其中N1,N2和N3病例的5年生存率分别为100％,68．0％和40．9％（χ^2=0.729,P=0.026),而单侧颈部,全颈部和扩大野照射者的5年生存率分别为66．5％,74．5％和54．6％（χ^2=1.38,P=0.501),Cox比例风险模型分析发现颈淋巴结分期对生存率的影响有显著性意义（P＝0．032）,5年颈部局部控制率为65．6％,其中N1,N2和N3病例的5年局部控制率分别为100％,63．2％和34．6（χ^2=5.51,P=0.064),而单侧颈部,全颈部和扩大野照射者的5年局部控制率分别为87．6％、51．0％和72．7％（χ^2=2.55,P=0.279）,5年原发病灶的出现率为21．2％,小野（单侧颈部或全颈部照射）和扩大野照射的5年原发灶出现率分别为23．3％和12．5％（χ^2=0.52,P=0.469),结论：颈淋巴结的临床分期是影响生存率的重要预后因素,并且随着期别的升高,颈部局控率有下降的趋势;小野较扩大野照射的原发灶出现率有增加的趋势,但不同大小照射野治疗的颈部局部治疗率和生存率无明显差异。     

53例嗅神经母细胞瘤的临床分析

背景与目的：嗅神经母细胞瘤患者预后不良,如何提高治疗效果、延长患者的生存期是临床研究中亟需解决的问题。本研究探讨影响嗅神经母细胞瘤预后的因素及合理的治疗方法。方法：回顾性分析1980～2003年间我院收治的53例嗅神经母细胞瘤患者的临床资料,采用Kaplan—Meier法分析嗅神经母细胞瘤的临床特征、治疗方式与预后的关系,并比较不同治疗方式的疗效。结果：本组患者总5年生存率为41％。单纯手术组、单纯放疗组、单纯化疗组、手术联合放化疗组和放疗联合化疗组患者的5年生存率分别为42％、38％、0％、56％、0％,采用不同治疗方式患者的生存率比较差异有统计学意义（P〈0．05）。Kadish临床分期A期、B期、C期5年生存率分别为100％、37％、31％,不同临床分期患者生存率比较差异有统计学意义（P〈0．05）。复发率51％,复发组、无复发组5年生存率分别为42％、48％。结论：嗅神经母细胞瘤复发率高,以手术为主的综合治疗方案是较优的治疗模式。预后与临床分期、治疗方式有关。     

原发扁桃体非霍奇金淋巴瘤的预后因素

目的：评价原发扁桃体非霍奇金淋巴瘤（NHL）的肿瘤侵犯范围（T分期）和国际预后指数（IPI）的预后价值,并对早期患者提出治疗建议。方法：回顾分析306例原发扁桃体NHL,根据Ann Arbor分期,I期35例,II期178例,Ⅲ期49例,Ⅳ期44例,根据1997年AJCC TNM分期标准,TI 29例,T2 142例,T3 117例,T4 18例,I期单纯放射治疗12例,综合治疗23例,Ⅱ期单纯放射治疗57例,单纯化疗2例,综合治疗119例,Ⅲ,Ⅳ期以化疗为主,结果：T1,T2,T3和T4的5年癌症相关生存率（CSS）分别为73．8％,59．0％,56．5％和26．5％（P＜0．05）,IP1评分0分,1分和2或3分的5年CSS分别为69．9％,49．0％和25．0％（P＜0．01）,II期单纯放疗和综合治疗的5年无瘤生存率（DFS）分别为46．2％和60．4％（P＜0．05）,多因素分析证明,影响预后的因素有一般状态,B症状,Ann Arbor分期,T分期和IPI,结论：原发肿瘤T分期和IPI是扁桃体NHL重要的预后因素,综合治疗改善了II期扁桃体NHL的DFS。     

嗅神经母细胞瘤31例综合治疗分析

[目的]总结嗅神经母细胞瘤的临床特点及其治疗。[方法]2000年至2008年治疗31例嗅神经母细胞瘤,Kadish分期：A期2例、B期16例、C期13例。采用单纯手术1例,30例综合治疗,其中11例加用辅助化疗。[结果]全组总的3年累积生存率为83．5％,5年累积生存率为60．7％：Kadish’s A期、B期和C期的5年累积生存率分别为100％、70-3％和40．4％（P=0．03）。晚期患者手术＋放疗组、手术＋放疗＋化疗组的3年累积生存率分别为28．6％、50．0％。[结论]嗅神经母细胞瘤的预后与Kadish分期相关。手术加放疗的综合治疗是有效的治疗策略,晚期患者的辅助化疗是必要的。     

宫颈癌术后不同因素对放疗疗效的影响

目的 观察宫颈癌术后不同因素对放疗远期疗效的影响。方法 1998年收治的各期宫颈癌共525例，其中346例手术治疗，术后放疗者302例。302例分布在Ⅰ、Ⅱa、Ⅱb、Ⅲa期，分别为142、121、23、16例。术后放疗采用^60Coγ线或6MVX线前后野垂直交替照射44～50Gy4～5周。根据存在的因素情况酌情扩大射野、缩野加照或阴道后装治疗及少数给予辅助化疗。结果 Ⅰ、Ⅱa、Ⅱb、Ⅲa期5年生存率分别为89．4％、77．7％、56．5％、56．2％（X^2=22．22，P〈0．01）。浸润浅层、深肌层、全层的5年生存率分别为94．8％、83．1％、62．7％（x0=27．46，P〈0．01）。盆腔内淋巴结转移、脉管瘤栓、残端及宫旁切缘呈阳性的有与无者5年生存率分别为52．3％与88．2％（X^2=41．79，P〈0．01）。结论 对术后有多种影响因素的患者，术后放疗是必要的，它可减少盆腔复发率。凡认为手术是宫颈癌主要治疗手段，有术后放化疗就可放宽手术适应证是不可取的。     

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。     

鼻咽非霍奇金淋巴瘤的临床与预后分析

目的 探讨鼻咽非霍奇金淋巴瘤的临床特点、治疗及国际预后指数(IPI)的应用价值。方法 回顾性分析1983—1997年间136例首程治疗的鼻咽非霍奇金淋巴瘤患者的临床资料。按照工作分类原则进行分类,高度恶性18例,中度恶性77例,低度恶性2例,未分类39例。根据Ann Arbor分期,Ⅰ期25例,Ⅱ期91例,Ⅲ期12例,Ⅳ期8例。Ⅰ期单纯放疗13例,综合治疗12例;Ⅱ期单纯放疗31例,综合治疗57例,Ⅲ和Ⅳ期以化疗为主。结果 5年和10年总生存率(OS)、癌症相关生存率(CSS)和无病生存率(OFS)分别为56．2％和48．3％,61．2％和58．0％,51．1％和46．5％。IPI为0,1及2～3分的5年CSS分别为70．9％、44．9％、30．0％(P=0．004)。Ⅰ期化放疗综合治疗和单纯放射治疗的5年CSS分别为82．2％和83．1％,10年CSS分别为82．2％和66．4％,差异无显著性(P=0．779)。Ⅱ期综合治疗和单纯放射治疗5年CSS分别为70．9％和46．0％,10年CSS分别为65．4％和46．0％,差异有显著性(P=0．04)。Cox多因素分析显示,影响预后的因素为Ann Arbor分期、B组症状和IPI。结论 IPI是判断原发于鼻咽非霍奇金淋巴瘤预后的重要指标,Ⅱ期鼻咽非霍奇金淋巴瘤应考虑综合治疗。     

Outcome analysis for stage IE and IIE thyroid lymphoma

Previous reports have revealed modest results in the management of thyroid lymphoma with radiotherapy alone. This retrospective report evaluates the outcome of patients treated for thyroid lymphoma with radiotherapy alone and with combined modality therapy (chemotherapy and radiotherapy) at a single institution. Twenty-seven patients with stages IE and IIE non-Hodgkin's lymphoma of the thyroid gland were treated between 1960 and 1998 at Barnes-Jewish Hospital, of which 14 patients were stage IE and 13 patients were stage IIE. The median age at diagnosis was 67 years, and there were 21 females and 6 males evaluated. The median follow-up time was 38 months (range: 3-279 months). All patients had histologically proven non-Hodgkin's lymphoma, of which 22 patients (81%) were intermediate grade. Treatment consisted of radiotherapy alone in 19 patients and a combined modality therapy in 8 patients. The median radiation dose to the thyroid bed was 44 Gy, and most patients received a doxorubicin-containing regimen administered prior to radiotherapy. Patient, tumor, and treatment-related characteristics were evaluated using Cox regression analysis. Local-regional tumor control, disease-free survival (DFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Four patients had local relapse in this series, with a crude local tumor control rate of 85%. No factor was determined to be significant for local tumor control. The actuarial 5-year DFS and OS for the entire cohort were 57%, and 56%, respectively. In terms of DFS, both age and stage were statistically significant. The 5-year actuarial DFS for patients less than age 65 years was 83% versus 37% for those more than this age (p = 0.024). Furthermore, the 5-year actuarial DFS for patients with stage I and II disease was 69% and 45%, respectively (p = 0.022). In multivariate analysis, age continued to be significant for DFS (p = 0.049). Overall survival analysis revealed age, local tumor control, and stage to be significant in univariate analysis. Multivariate analysis was further carried out using Cox proportional hazard model, and it revealed age (p = 0.006) and local tumor control (p = 0.007) to be significant. Primary thyroid gland lymphomas have a favorable outcome with appropriate therapy, but prognosis depends on both clinical stage and age at presentation. Because of the risk of both local-regional and distant failure, combined modality approaches that use chemotherapy with radiotherapy are warranted for intermediate- and high grade thyroid lymphoma.     

Primary non-Hodgkin's lymphoma of the nasopharynx: prognostic factors and outcome of 113 Indian patients

This single institutional study evaluated the prognostic factors and treatment outcome of 113 Indian patients with primary nasopharyngeal non-Hodgkin's lymphoma. At presentation, 28% had stage I and 62% had stage II disease. Treatment comprised of a combination of chemotherapy (CTh) and radiotherapy (RT) in the majority of the patients (76%). After a median follow-up of 56 months, the 5-year disease-free survival (DFS) and overall survival (OS) for the whole group were 55.8% and 57.9%, respectively. Multivariate analysis showed that; age > 30 years [hazard ratio (HR) = 6.59, 95% confidence interval (CI) = 2.59 - 16.7, P < 0.0001], WHO performance score > or = 2 (HR = 2.34, 95% CI = 1.01 - 5.46, P = 0.050), T-cell lymphomas (HR = 2.81, 95% CI = 1.14 - 6.96, P < 0.001) and the presence of B symptoms (HR = 3.65, 95% CI = 1.77 - 7.53, P = 0.025), had a negative influence on survival. Patients treated with a combination of CTh and RT had a significantly better outcome than those treated with CTh alone (OS: 69%vs. 31%, P < 0.00001). HR for death in the CTh alone group was 3.73 (95% CI = 1.95 - 7.13). The CR (P = 0.01), DFS (P = 0.01) and OS (P = 0.03) rates were significantly better for patients receiving a RT dose of > or =4500 cGy. HR in the subgroup that received a RT dose of <4500 cGy was 2.51 (95% CI = 1.04 - 6.06). These results suggest that combined modality treatment, comprising of CTh and RT (with an RT dose of > or =4500 cGy), results in satisfactory outcome in patients with this rare neoplasm.     

97例ⅠA 期霍奇金淋巴瘤患者的疗效分析

背景与目的:有研究表明霍奇金淋巴瘤(Hodgkin's lymphoma,HL)的治疗应根据临床分期和危险因素不同而采取不同的综合治疗策略,但Ⅰ A期HL的最佳治疗方案尚未明确,本研究对Ⅰ A期HL的治疗和预后情况进行回顾性分析.方法:根据预后因素将97例临床Ⅰ A期HL患者分为预后非常好(very favorable,VF)组、预后好(favorable,F)组和预后不好(unfavorable,UF)组,并分析其总生存(overall survival,OS)率、无病生存(disease-free survival,DFS)率、第二原发肿瘤和死亡原因,多因素分析影响预后的因素.结果:VF组、F组和UF组分别有7例(7.2%)、72例(74.2%)和18例(18.6%).全组患者的中位随访时间为65个月.接受治疗后90例(92.8%)患者达完全缓解(CR),其5年和10年OS率分别为87.7%和76.3%,5年和10年DFS率分别为79.4%和74.5%.VF组、F组、UF组的5年OS率分别为100%、88.9%、78.1%,10年OS率分别为100%、88.4%、39.1%(P=0.292);5年DFS率分别为100%、86.3%、73.6%,10年DFS率分别为87.2%、71.8%、34.5%(P=0.032).多因素分析表明,影响OS的因素包括病理类型(P=0.056)和是否复发(P=0.001),近期疗效是影响DFS的主要因素(P=0.024).全组复发率为18.6%,单纯放疗和联合放化疗者的复发率差异无统计学意义(x2=0.072,P=0.788).第二原发肿瘤的发生率为5.2%,其中2例为非霍奇金淋巴瘤.死亡12例(12.4%),均为单纯放疗患者.结论:临床Ⅰ A期HL患者单纯放疗或联合放化疗90%以上可达CR.联合放化疗的远期疗效均优于单纯放疗.病理类型、首次治疗疗效和是否复发是Ⅰ A期HL患者生存的主要影响因素.     

Treatment results and prognostic factors in primary thyroid lymphoma patients: a Rare Cancer Network study

Background: This study analyzed prognostic factors and treatment outcomes of primary thyroid lymphoma.Patients and Methods: Data were retrospectively collected for 87 patients (53 stage I and 34 stage II) with median age 65 years. Fifty-two patients were treated with single modality (31 with chemotherapy alone and 21 with radiotherapy alone) and 35 with combined modality treatment. Median follow-up was 51 months.Results: Sixty patients had aggressive lymphoma and 27 had indolent lymphoma. The 5- and 10-year overall survival (OS) rates were 74% and 71%, respectively, and the disease-free survival (DFS) rates were 68% and 64%. Univariate analysis revealed that age, tumor size, stage, lymph node involvement, B symptoms, and treatment modality were prognostic factors for OS, DFS, and local control (LC). Patients with thyroiditis had significantly better LC rates. In multivariate analysis, OS was influenced by age, B symptoms, lymph node involvement, and tumor size, whereas DFS and LC were influenced by B symptoms and tumor size. Compared with single modality treatment, patients treated with combined modality had better 5-year OS, DFS, and LC.Conclusions: Combined modality leads to an excellent prognosis for patients with aggressive lymphoma but does not improve OS and LC in patients with indolent lymphoma.     

Early stage nasal NK/T-cell lymphoma: clinical outcome,prognostic factors,and the effect of treatment modality

PURPOSE: To determine the clinical outcome, prognostic factors, and effect of adding combination chemotherapy to radiation therapy on disease control and survival in early stage nasal natural killer (NK)/T-cell lymphoma. METHODS AND MATERIALS: A retrospective "intent to treat" analysis was carried out on 79 patients treated consecutively with curative intent between 1977 and June 2001. They all had early stage (Ann Arbor Stage I(E): 63, II(E):16) nasal NK/T-cell lymphoma. Sixty-one were planned for combined modality treatment (CMT); radiotherapy alone (RT) was intended for 18. Three to 6 cycles of anthracycline-containing regimens were aimed at for patients intended for CMT. Patients selected for RT were generally older or treated during the earlier part of the study period. RESULTS: The overall complete response (CR) rate was 68.4% (54/79), of whom 44.4% (24/54) relapsed after 54.9 months median follow-up of the survivors. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 35.5% and 37.9%, respectively. On multivariate analysis, good performance status (Eastern Cooperative Oncology Group [ECOG] <2) was shown to be a significant favorable factor for DFS (p = 0.011), whereas good performance status (ECOG <2) and Ann Arbor Stage I(E) disease were shown to be significant favorable factors for OS (p = 0.001 and p = 0.013, respectively). The type of intended treatment was not a significant factor for DFS (5-year DFS CMT vs. RT = 35.8% vs. 30.5%, p = 0.795) or OS (5-year OS CMT vs. RT = 40.3% vs. 29.8%, p = 0.693) though only 2 of the 16 Stage II(E) patients were intended for RT alone. Resistance to treatment, especially to chemotherapy, was common. Of 61 patients intended to be given CMT, 31 showed disease progression while receiving chemotherapy, of whom 17 progressed locoregionally. Nine of the latter group were rendered CR by salvage radiotherapy. CONCLUSIONS: The overall outcome in early stage nasal NK/T-cell lymphoma is poor. Performance status and Ann Arbor stage are significant factors influencing DFS and OS. The addition of anthracycline-containing chemotherapy to radiotherapy does not appear to confer any survival benefit in Stage I(E) patients. Therefore, radiation therapy remains the mainstay of treatment for this lymphoma type.