共查询到20条相似文献,搜索用时 125 毫秒
1.
目的 分析早期上呼吸消化道结外NK/T细胞淋巴瘤(UADT ENKTCL)放疗联合以门冬酰胺酶/培门冬酶为主的化疗疗效及预后因素。方法 收集2003—2020年间贵州省肿瘤医院收治的 267例早期UADT ENKTCL患者,其中放疗或联合门冬酰胺酶/培门冬酶为主要方案化疗的 229例,单纯放疗或化疗的 38例。Kaplan-Meier计算总生存(OS)、无进展生存(PFS)并log-rank法检验和单因素分析,Cox模型多因素分析。结果 全组 5年OS、PFS分别为67.2%、61.5%;放化综合治疗、单纯放疗、单纯化疗的 5年OS分别为71.7%、35%、49%(P<0.001),5年PFS分别为66%、35%、28%(P<0.001)。放化疗患者基于NRI危险分层分为预后良好、预后不良组,5年OS分别为93.3%、64.3%(P<0.001),5年PFS分别为91.1%、56.7%(P<0.001);放疗剂量≥50Gy、<50Gy组 5年OS分别为72.4%、55.7%(P<0.001),5年PFS分别为68.3%、36.5%(P<0.001)。预后不良组化疗周期数≥4个、<4个的 5年OS分别为65.5%、59.2%(P=0.049),5年PFS分别为60.7%、50.6%(P=0.018)。单因素分析显示Ⅱ期、ECOG≥2分、超腔、单纯放疗、NRI≥1分、EB病毒-DNA≥2750 copies/ml、放疗剂量<50Gy,化疗周期数<4个为 5年OS及PFS的预后不良因素(均 P<0.05);CHOP类化疗方案仅为PFS的预后不良因素(P<0.05)。多因素分析显示超腔、ECOG≥2分、放疗剂量<50Gy均为OS和PFS的预后不良因素(均 P<0.05),Ⅱ期为OS的预后不良因素(P<0.05)。结论 早期低危UADT ENKTCL预后良好;足够剂量的扩大受累野放疗是早期UADT ENKTCL根治性手段;综合治疗较单纯放疗能改善早期预后不良组患者的预后;足疗程化疗能显著改善预后不良组的远期生存,门冬酰胺酶为基础的化疗均能较好的改善早期UADT ENKTCL的预后。 相似文献
2.
3.
目的 分析早期结外NK/T细胞淋巴瘤(ENKTCL)使用诱导化疗联合放疗的疗效及预后因素。方法 2003—2021年间贵州医科大学附属肿瘤医院收治287例早期ENKTCL患者,接受诱导化疗联合放疗的综合治疗,分析早期NKTCL的临床预后相关因素。Kaplan-Meier计算总生存(OS)、无进展生存(PFS)及log-rank法检验和单因素分析,Cox模型多因素分析。结果 全组5年OS、PFS分别为72.8%、68.9%;基于改良的Nomogram风险指数(NRI)预后模型分为低危组(0分)、中低危组(1分)、中高危组(2分)、高危组(3分)和极高危组(≥4分)的5年OS分别为95.6%、76.3%、69.5%、61.0%和23.3%(P<0.001),5年PFS分别为93,2%、69.8%、64.6%、60.2%和23.3%(P<0.001)。放疗剂量≥50Gy和<50Gy组5年OS分别为73.8%和65.9%(P=0.123),5年PFS分别为72.8%和45.3%(P=0.001)。诱导化疗近期疗效为CR、PR、SD、PD的5年OS分别为85.4%、74.0%、61.8%、28.5%(P<0.001),5年PFS分别为83.7%、66.8%、65.7%、27.4%(P<0.001)。单因素分析显示Ⅱ期、ECOG≥2分、超腔、放疗剂量<50Gy、诱导化疗近期疗效为5年OS及PFS的预后不良因素(均P<0.05),多因素分析显示超腔、ECOG≥2分、Ⅱ期为OS预后不良因素(均P<0.05),而超腔、ECOG≥2分为PFS的预后不良因素(均P<0.05)。结论 早期结外NK/T细胞淋巴瘤采用以诱导化疗联合足量放疗能取得较好疗效;对诱导化疗近期疗效能够达到完全缓解预后良好。 相似文献
4.
5.
背景与目的:结外NK/T细胞淋巴瘤的临床及预后存在明显的异质性,以早期病变为主,常见原发灶局部外侵,早期患者放疗为主要治疗手段。本研究旨在分析早期结外NK/T细胞淋巴瘤患者的临床特征、治疗方案、生存预后及可能影响预后的相关因素。方法:收集河北医科大学第四医院2010年1月—2015年12月病理证实的早期NK/T细胞淋巴瘤患者99例,发病平均年龄45.5岁(6~76岁),男女发病比例2.1∶1;56.6%患者伴有B症状;单纯放疗7例,单纯化疗29例,放化综合治疗63例;中位放疗剂量52 Gy(34~60 Gy),含左旋门冬酰胺酶或培门冬酶化疗患者73例,不含19例,中位化疗周期为6个(1~12个)。结果:全组患者中位生存时间59.9个月,中位局控时间73.5个月。全组患者1、2和5年总生存率分别为76.8%、68.8%和61.4%;1、2和5年局控率分别为84.5%、81.6%和78.3%;1、2和5年无远处失败生存率分别为83.4%、83.4%和76.8%。单纯放疗或放化疗与单纯化疗比较,5年总生存率为66.0%和47.3%(χ2=4.782,P=0.029),5年局控率为85.8%和58.7%(χ2=5.949,P=0.015)。不伴原发肿瘤侵犯(primary tumor invasion,PTI)患者与伴有PTI患者比较,5年总生存率为71.5%和55.5%(χ2=4.950,P=0.026);5年局控率为81.5%和72.0%(χ2=0.983,P=0.321)。全组近期疗效评价达CR者62例(62.6%),治疗有效率83.8%,疾病控制率85.8%。评价CR患者与非CR患者5年生存率为84.1%和27.6%(χ2=31.566,P=0.000);5年局控率为92.2%和52.4%(χ2=18.417,P=0.000)。结论:早期结外NK/T细胞淋巴瘤患者单放或放化综合治疗比单纯化疗疗效好,与生存有关的独立预后因素有Ann Arbor分期和乳酸脱氢酶(lactate dehydrogenase,LDH),与局控有关的独立预后因素仅有LDH。 相似文献
6.
7.
目的 探讨治疗前血清Hb水平对早期结外鼻型NK/T细胞淋巴瘤预后的影响。 方法 回顾分析2000—2015年间收治的 175例Ⅰ、Ⅱ期结外鼻型NK/T细胞淋巴瘤。纳入标准为原发病灶位于上消化呼吸道,不合并其他恶性疾病,治疗及随访记录完整病例纳入分析。接受单纯化疗 67例、单纯放疗 8例、放化疗 100例。Kaplan-Meier法计算生存率,Logrank法单因素分析,Cox模型多因素分析。 结果 175例患者的变量单因素分析显示疗前血清Hb水平(≥120 g/L)、LDH水平(正常)、ECOG评分(0~1)、Ann Arbor分期(ⅠE)、接受放疗显著提高PFS及OS (P=0.000~0.046)。多因素分析显示血清Hb水平、LDH水平、ECOG评分、Ann Arbor分期是患者PFS、OS影响因素(P=0.000~0.040)。 结论 疗前Hb≥120 g/L者预后好于<120 g/L者。 相似文献
8.
结外鼻型NK/T细胞淋巴瘤的研究进展 总被引:3,自引:0,他引:3
结外鼻型NK/T细胞淋巴瘤是鼻腔淋巴瘤中较为常见、恶性程度高且预后较差的病种。因此.了解其发生发展、临床表现、病理诊断、治疗及预后是非常重要的。 相似文献
9.
目的 分析区域淋巴结转移范围在Ⅱ期上呼吸消化道结外鼻型NK/T细胞淋巴瘤(UADT-NKTCL)患者中的预后价值。方法 回顾分析1987—2013年间本院初治的97例Ⅱ期UADT-NKTCL患者资料,分析淋巴结转移范围与预后关系。全组患者52例原发鼻腔,45例原发鼻腔外上呼吸消化道。多数患者接受以放疗为主治疗,65例接受放化疗,27例单纯放疗,5例单纯化疗。Kaplan-Meier法计算生存率,Logrank法检验和单因素预后分析,Cox模型多因素分析。结果 全组患者5年OS、PFS分别为57%、49%。单因素和多因素分析都显示伴有下颈(环状软骨下缘水平以下)淋巴结转移的患者预后更差,其中位生存时间仅19.3个月,2、5年OS分别为28%、11%,而未伴有下颈淋巴结受累的Ⅱ期患者5年OS达68%(P=0.000)。治疗模式明显影响预后,综合治疗患者5年OS、PFS分别为64%、52%,显著优于单纯放疗或化疗患者的40%(P=0.006)和42%(P=0.088)。结论 区域淋巴结受累水平是Ⅱ期UADT-NKTCL的独立预后因素,伴有下颈淋巴结受累患者预后很差。 相似文献
10.
目的 分析贫血在结外鼻型NK/T细胞淋巴瘤中的预后价值。方法 回顾分析 1225例在中国10个医疗中心确诊并且接受首程治疗的结外鼻型NK/T细胞淋巴瘤。中国贫血标准:海平面地区成年男性Hb<120 g/L,成年女性<110 g/L。贫血程度分级:极重度Hb≤30 g/L,重度 31~60 g/L,中度 61~90 g/L,轻度>90 g/L。结果 全组患者就诊时有 199例伴有贫血,占16.2%。贫血患者具有更多预后不良因素,贫血患者中分期为Ⅱ—Ⅳ期、中位年龄>60岁、ECOG评分2—4分、NK/T细胞淋巴瘤预后指数≥2分的比例较高。贫血、非贫血患者 5年OS分别为49.4%、63.3%(P<0.01),5年PFS分别为35.4%、56.0%(P<0.01)。单因素分析显示贫血、年龄、ECOG评分、B组症状、乳酸脱氢酶、原发部位、原发肿瘤侵犯以及分期是OS和PFS影响因素,多因素分析显示贫血仍然是预后影响因素。结论 贫血在结外鼻型NK/T细胞淋巴瘤中少见,这部分患者预后较差,贫血是预后影响因素。 相似文献
11.
Zhitao Ying Xuejuan Wang Yuqin Song Wen Zheng Xiaopei Wang Yan Xie Ningjing Lin Meifeng Tu Lingyan Ping Weiping Liu Lijuan Deng Chen Zhang Zhi Yang Jun Zhu 《中国癌症研究》2013,25(1):95-101
Objective: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease. The prognostic factor currently used is not accurate enough to predict the outcomes of patients with DLBCL. The prognostic significance of interim PET/CT in DLBCL remains controversial. The aim of this study is to determine the predictive value of interim 18F-FDG PET/CT after first-line treatment in patients with DLBCL. Methods: Thirty-two patients with DLBCL underwent baseline, interim and post-treatment 18F-FDG PET/CT scans. Imaging results were analyzed for the survival of patients via software SPSS 13.0, retrospectively. Results: Thirty-one of the 32 patients were treated with R-CHOP regimen, and interim 18F-FDG PET/CT of 24 patients was performed after 2 cycles of treatment. After a median follow-up period of 16.7 months, the 2-year progression-free survival (PFS) rates were significantly different between the groups above and below SUV max cut-off value of 2.5 (P=0.039). No significant differences were found in the 2-year PFS rates if SUV max cut-off values were set as 2.0 and 3.0, respectively (P=0.360; P=0.113). Conclusions: Interim PET/CT could predict the prognosis of DLBCL patients with the SUV max cut-off value of 2.5, but more clinical data should be concluded to confirm this conclusion. 相似文献
12.
Huang JJ Zhu YJ Xia Y Zhao W Lin TY Jiang WQ Huang HQ Li ZM 《Medical oncology (Northwood, London, England)》2012,29(3):2183-2190
Natural killer (NK)/T-cell lymphoma is a rare neoplasm with heterogeneous clinical behaviors. This study aimed to devise a prognostic model specifically for extranodal NK/T-cell lymphoma, providing risk stratification in affected patients. A total of 146 patients newly diagnosed with extranodal NK/T-cell lymphoma were retrospectively analyzed. Independent predictors of survival were determined by Cox regression analysis. The estimated 5-year overall survival rate for all patients was 41.9%. Both the International Prognostic Index and Korean NK/T-cell lymphoma Prognostic Index were prognostic in univariate analysis. The majority of our patients were in the low-risk International Prognostic Index and Korean NK/T-cell lymphoma Prognostic Index category (with no or one adverse factor), but both of these two prognostic models had no discriminating power within the subgroup of these patients. Absolute lymphocyte count at diagnosis, B symptoms, and advanced stage were independently predicted poorer survival. Cox analysis yielded a novel prognostic model based on these three parameters that categorized patients into one of three risk groups: Group 1 (57 cases, 39.0%), no adverse factors; Group 2 (43 cases, 29.5%), one adverse factor; and Group 3 (46 cases, 31.5%), two or three adverse factors. Five-year overall survival was 71.6% for Group 1, 55.5% for Group 2, and 0% for Group 3 (P < 0.0001). The novel prognostic model balanced the distribution of patients into different risk groups with better predictive discrimination. It may be useful to stratify patients with extranodal NK/T-cell lymphoma into different risk groups and provide more information for treatment selection. 相似文献
13.
《Expert review of anticancer therapy》2013,13(9):1395-1405
Extranodal natural killer/T-cell lymphoma (ENKL), a subtype of natural killer/T-cell malignancies, is a rare subset of lymphomas with significant biological and clinical heterogeneity. The prognosis of ENKL is variable and therapeutic approaches are not well established. The optimal dose, combination, and sequence of radiotherapy and chemotherapy are evolving, as is the role of stem cell transplantation. Radiotherapy is an essential component of therapy for early-stage disease. The clinical course of advanced disease is highly aggressive, with frequent chemotherapy resistance and a poor prognosis. For relapsed disease, asparaginase-based regimens have provided encouraging results and are currently under investigation in the frontline setting. Our article discusses the key aspects of biology, pathogenesis and clinical presentation that contribute to the heterogeneity, and proposes a stratified approach to the treatment of ENKL based on clinical, pathologic and biologic risk factors. Although considerable advances have been made in our understanding of the biology and prognosis of this lymphoma, it remains critical that all patients with a diagnosis of ENKL are enrolled and treated in clinical trials so that optimal therapies can be identified. 相似文献
14.
结外NK/T细胞淋巴瘤(ENKTL)是非霍奇金淋巴瘤中较为罕见的亚型,东亚地区比西方国家多见。主要发生在鼻腔或鼻窦区,皮肤受累少见。基于ENKTL的发病机理,几乎所有患者的淋巴瘤细胞中都存在EB病毒。EBV-DNA拷贝数与肿瘤负荷密切相关,并能预测ENKTL预后。由于P-糖蛋白的表达,使细胞产生耐药性,ENKTL预后较差。近年来,新的治疗方法的研究延长了ENKTL患者的生存期。对于局限期ENKTL放疗联合化疗已取得良好的疗效。对于晚期复发难治ENKTL以L-门冬酰胺酶为基础的化疗方案显著提高治疗有效率。有文献报道,造血干细胞移植在ENKTL的治疗中取得了重要地位,而靶向药物的出现为晚期ENKTL提供了新选择。本文综述了ENKTL的治疗进展。 相似文献
15.
16.
Karantanis D Subramaniam RM Peller PJ Lowe VJ Durski JM Collins DA Georgiou E Ansell SM Wiseman GA 《Clinical lymphoma & myeloma》2008,8(2):94-99
PurposeTo our knowledge, there are no published data pertinent to the use of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with natural killer (NK)/T—cell lymphoma. The purpose of this study was to assess the value of FDG PET/CT in this aggressive type of non-Hodgkin lymphoma.Patients and MethodsAll patients with NK/T-cell lymphoma referred for FDG PET/CT at our institution from July 2001 to July 2006 were retrospectively studied. PET/CT examinations were blindly reviewed by 2 experienced readers. The results were compared with the status of the disease, which was determined after evaluation of biopsy, laboratory, clinical and conventional imaging examination, and follow-up results. PET/CT results were thereby classified as true-positive, true-negative, false-positive, or false-negative. The degree of FDG uptake in the positive lesions was semiquantified using maximum standard uptake value (SUVmax).ResultsTwenty-one PET/CT examinations were performed in 10 patients with NK/T-cell lymphoma. For nasal disease, PET/CT was true-positive in 5 cases, true-negative in 15 cases, and positive but unconfirmed in 1 case. For extranasal disease, PET/CT was true-positive in 3 cases, true-negative in 16 cases, and false-negative in 2 cases. The mean SUVmax in PET-positive lesions in nasal cavities or paranasal sinuses was 16 gm/mL (range, 5–25 gm/mL; median, 19.3 gm/mL). In extranasal disease, the mean SUVmax was 10.9 gm/mL (range, 4.6–34.1 gm/mL; median, 5.6 gm/mL).ConclusionViable NK/T-cell lymphoma is intensely FDG hypermetabolic. PET/CT appears to be sensitive for the detection of disease in the nasopharynx and, to a lesser extent, in extranasal sites. 相似文献
17.
18.
Jae-Ryong Shim Seung Duk Lee Sung-Sik Han Sang Jae Lee Dong Eun Lee Seok-Ki Kim Seong Hoon Kim Sang Jae Park Jae-Hwan Oh 《European journal of surgical oncology》2018,44(5):670-676
Introduction
Colorectal cancer liver metastasis (CRLM) can be cured with surgery. To improve survival, optimal selection of CRLM patients should be done cautiously, which may be facilitated by preoperative [F-18] fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).Methods
A total of 245 patients with CRLM between February 2007 and January 2015 were retrospectively studied. All clinical variables, pathological data, and various PET/CT parameters were correlated with disease-free survival (DFS) and overall survival (OS). Metastatic tumor maximum standardized uptake value (SUVmax) and normal liver mean SUV (SUVmean) ratio was selected for group classification.Results
The median DFS in months were 24.5 months and median OS were 41.7 months. Multivariate analysis found an increased risk of worse prognosis in DFS for primary colon cancer T3~T4, N2 stage, neoadjuvant chemotherapy, synchronous metastasis, multiple metastatic tumor number and metastatic tumor SUVmax/normal liver SUVmean ratio >4.3. The DFS rate of each group classified by SUV ratio was 58.1%, 39.0%, and 33.6% vs. 39.3%, 20.8%, and 15.8% at 1, 3, and 5 years (p = 0.017). Patients with multiple tumors and SUV ratio of >4.3 showed worst survival (OS rate: 74.2%, 41.5%, and 24.2%, p = 0.001 at 1, 3, and 5 years, respectively).Conclusions
PET/CT variables can be a valuable prognostic factor in patients with CRLM for the prediction of recurrence. Preoperative PET/CT may improve risk stratification and optimize outcomes of patients with CRLM. 相似文献19.
[目的]探讨18F-FDGPET/CT显像在淋巴瘤治疗疗效评价中的价值。[方法]回顾分析87例淋巴瘤患者治疗后18F-FDGPET/CT显像结果。并与CT图像进行对比分析,评价18F-FDGPET/CT显像在淋巴瘤治疗疗效评价中的价值。[结果]18F-FDGPET/CT对97.70%(85/87)淋巴瘤治疗后患者进行了准确疗效评价。而单纯CT对74.71%(65/87)的淋巴瘤患者进行了准确评价。18F-FDGPET/CT在诊断准确性方面明显优于单纯CT,差异有显著性。[结论]18F-FDGPET/CT在淋巴瘤疗效评价方面具有重要临床应用价值。 相似文献
20.