早期结外鼻型NK/T细胞淋巴瘤治疗后淋巴结失败患者的预后分析 |
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引用本文: | 陈波,李晔雄,刘清峰,金晶,王维虎,王淑莲,刘跃平,宋永文,房辉.早期结外鼻型NK/T细胞淋巴瘤治疗后淋巴结失败患者的预后分析[J].白血病.淋巴瘤,2014,23(5):261-265. |
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作者姓名: | 陈波 李晔雄 刘清峰 金晶 王维虎 王淑莲 刘跃平 宋永文 房辉 |
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作者单位: | 陈波 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); 李晔雄 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); 刘清峰 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); 金晶 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); 王维虎 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); 王淑莲 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); 刘跃平 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); 宋永文 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); 房辉 (100021,北京协和医学院中国医学科学院肿瘤医院放疗科); |
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基金项目: | 北京市自然科学基金(项目编号:7132184) |
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摘 要: | 目的分析Ⅰ-Ⅱ期原发上呼吸消化道NK/T细胞淋巴瘤(UADT—NKTCL)治疗后淋巴结失败患者的生存和预后因素。方法1988年4月至2012年12月40例Ⅰ-Ⅱ期UADT—NKTCL患者在接受治疗后的随访中出现了淋巴结失败,对失败后的生存和预后进行分析。采用Kaplan—Meier法计算生存率。结果40例患者中,8例单纯区域淋巴结失败,26例单纯远处淋巴结失败,6例同时合并区域和远处淋巴结失败。57.1%(8/14)的患者区域淋巴结失败合并局部复发,71.9%(23/32)的患者远处淋巴结失败合并远处器官失败。全组患者淋巴结失败后中位生存时间为8.7个月,2年总生存率29.8%。预后分析显示,淋巴结失败时患者B症状和美国东部肿瘤协作组(ECOG)评分是预后因素。有B症状的患者中位生存时间为6.6个月,而无B症状的患者为16.3个月,两者差异有统计学意义(P=0.034)。ECOG评分0~1分的患者中位生存时间显著长于ECOG评分1〉2分的患者,分别为31.6个月和4.1个月(P〈0.001)。综合治疗的预后显著优于单纯化疗,2年生存率分别为68.6%和15.0%(P〈0.001)。结论早期UADT-NKTCL治疗后出现淋巴结失败的患者总体预后差,挽救性综合治疗可取得较好效果。
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关 键 词: | 淋巴瘤,结外NK-T细胞 综合疗法 淋巴结失败 因素分析 |
Prognosis of lymph node failure patients after treatment for early stage extranodal nasal-type NK/T-cell lymphoma |
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Abstract: | Objective To evaluate the survival and prognostic factors of patients with lymph node failure after treatment for early stage upper aerodigestive tract NK/T-cell lymphoma (UADT-NKTCL). Methods Between April 1988 and December 2012, 40 patients with I and 1I UADT-NKTCL who developed lymphatic failure after treatment were reviewed. Survivals were estimated using the Kaplan-Meier method. Results Of 40 patients, 8 patients developed regional lymphatic failure, 26 patients developed distant lymphatic failure, and 6 patients had both regional and distant lymphatic failure. 57.1% (8/14) patients with regional lymphatic failure also had local relapse, and 71.9 % (23/32) patients with distant lymphatic failure had distant extranodal failure. The 2-year overall survival (OS) rate after lymphatic failure was 29.8 %, with a median survival of 8.7 months. B symptoms and ECOG status after lymphatic failure were prognostic factors. The median survivals of patients with or without B symptoms were 6.6 months and 16.3 months (P = 0.034), respectively. The patients with good status (ECOG score = 0-1) after lymphatic failure had better median survivals than those with poor status (ECOG score ~〉2) (31.6 months vs 4.1 months, P 〈 0.001). In addition, patients who received salvage combined modality therapy had better OS than received salvage chemotherapy alone, with the 2-year OS rates of 68.6 % and 15.0 % (P 〈 0.001), respectively. Conclusions Early stage UADT-NKTCL patients with lymphatic failure has poor prognosis. Salvage combined-modality therapy could achieve better outcome. |
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Keywords: | Lymphoma extranodal NK-T-cell Combined modality therapy Lymph node failure Factor analysis |
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