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(x2=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(x2=7.5266,P=0.0061)、CD3升高(x2=9.0912,P=0.0266)和治疗结束达到CR(x2=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.

Efficacy of radiotherapy on nasal natural killer/T-cell lymphoma and prognostic analysis

Objective To retrospectively analyze the efficacy of radiotherapy on nasal NK/T-cell lymphoma, and to explore the prognostic factors. Methods Between January 2000 and December 2008, 62 patients with nasal NK/T-cell lymphoma were treated with radiotherapy in our hospital. Their clinic data and efficiency were reviewed retrospectively. Kaplan-Meier methods were applied in unifactorial analysis and the COX regression model was applied in multivariate analysis. Results The median overall survival time was 69.7 months (95 % CI, 63.0-78.0 months), and 3, 5-year survival rate was 66.1% and 46.8 %. Metastasis was 61.8 % for the first reason which resulted in failure. The median survival time was 72.6 months in the increased group of numbers of T lymphocyte CD3 and 39.6 months in the decreased group, the difference was significant(x2 =4.9309, P =0.0264). Multivariate analysis confirmed that modified IPI 0-1 (x2 = 7.5266, P =0.0061), the numbers increased for CD3 (x2 =9.0912, P =0.0266), and complete remission(x2 = 9.0912, P =0.0106) were significant favorable prognostic factors for survival. Conclusion The radiotherapy was effective for patients with nasal NK/T-cell lymphoma, but was failure on account of distant metastasis, so systematic therapy still has an important role. modified IP1 0-1, the number increased for CD3 and complete remission were significant favorable prognostic factors for survival.