结外鼻型NK/T细胞淋巴瘤放化疗研究进展

结外鼻型NK/T细胞淋巴瘤（extranodal NK/T-cell lymphoma，nasal type ENKTL）是侵袭性非霍奇金淋巴瘤的一种特殊类型，由于发病率低，目前临床治疗证据大部分来自回顾性分析或小样本的Ⅱ期临床试验，缺乏大型的随机对照研究，暂无统一的治疗标准。放疗、化疗是ENKTL的主要治疗方法，但目前放、化疗策略选择仍存在争议性，是否联合放化疗、放化疗联合方式、化疗方案选择等方面均未形成统一的认识。对于早期（Ⅰ/Ⅱ期）患者目前多以放疗联合化疗的治疗方法，Ⅲ/Ⅳ期患者多采用以全身化疗为主。以L-门冬酰胺酶（L-ASP）为基础的化疗药物在各期及复发难治性ENKTL中疗效结果显示均较CHOP或CHOP样化疗方案好。最佳的化疗方案以及化疗与放疗结合方式仍需通过更多的、更大型的Ⅲ期随机对照试验来证实。寻找准确的预后因素进行风险分层，根据风险分层结果进行治疗是未来的研究热点和方向。本文将有关放、化疗的研究进展进行综述，以期对该病的治疗提供参考性指导。

Research progress of extranodal NK/T cell lymphoma in radiotherapy and chemotherapy

Extranodal NK/T-cell lymphoma，nasal type （ENKTL) is a special type of non-Hodgkin's lymphoma.Because of low incidence，most of current clinical treatment evidences are from retrospective analysis or phase II clinical trials of small samples.Due to lack of large randomized controlled trials，treatment criteria for this disease have not been set up.Radiotherapy and chemotherapy are main treatments for this disease，but therapeutic strategy is still controversia.Whether combine radiotherapy and chemotherapy，how to combine radiotherapy and chemotherapy still have not been a consensus.For stageⅠ－Ⅱ，the combination of chemotherapy and radiotherapy has better therapeutic effects．As for stage Ⅲ－Ⅳ ENKTL，the chemotherapy is the main treatment method.L-ASP-based chemotherapy regimens treated in each period have showed good results compared with CHOP or CHOP like chemotherapy regimens.The optimal chemotherapy regimen and the way of radiotherapy combined with chemotherapy still need to be supported by more large phase Ⅲ randomized controlled trials.Selection of an optimal therapy according to proper risk stratification in ENKTL is necessary to further improve the clinical outcome.It will become a new focus about treatment for ENKTL.This review mainly focuses on the advance of radiotherapy and chemotherapy for ENKTL in order to provide reference.