CAJ | 학술논문

目的探讨影响IE期鼻腔非霍奇金淋巴瘤患者预后的因素。方法 71例原发于鼻腔非霍奇金淋巴瘤IE期患者，其中37例病灶局限于鼻腔(IE局限组)，34例有鼻腔外侵犯（IE超腔组）。44例为单纯放疗，27例为放疗加化疗。生存统计采用Kaplan-Meier法，组间比较采用Log-rank检验。多因素分析采用Cox模型。结果放疗后肿瘤完全消失者5，10年生存率分别为71.9％和59.7％，放疗后残留者均为13.9％（P=0.000 4）。IE局限组5，10年生存率分别为69.8%和56.7%，IE 超腔组分别为40.7％和35.6%，二者差异有显著性（P=0.004 7）。年龄≤44岁患者的预后明显好于年龄>44岁者（P=0.000 3）。IE局限放疗加化疗组和单纯放疗组的10年生存率分别为75.0%和52.0%，IE超腔组则分别为45.0%和37.6%(P=0.064 4)。有无B症状对生存率无显著影响（P=0.792）。Cox多因素分析显示，放疗近期疗效、肿瘤超腔和年龄是影响预后的独立因素。结论鼻腔IE期淋巴瘤的治疗以放疗为主，加上化疗能提高远期生存率。放疗近期疗效、临床分期和年龄对预后有显著影响。
목적탐토영향IE기비강비곽기금림파류환자예후적인소。방법 71례원발우비강비곽기금림파류IE기환자，기중37례병조국한우비강(IE국한조)，34례유비강외침범（IE초강조）。44례위단순방료，27례위방료가화료。생존통계채용Kaplan-Meier법，조간비교채용Log-rank검험。다인소분석채용Cox모형。결과방료후종류완전소실자5，10년생존솔분별위71.9％화59.7％，방료후잔류자균위13.9％（P=0.000 4）。IE국한조5，10년생존솔분별위69.8%화56.7%，IE 초강조분별위40.7％화35.6%，이자차이유현저성（P=0.004 7）。년령≤44세환자적예후명현호우년령>44세자（P=0.000 3）。IE국한방료가화료조화단순방료조적10년생존솔분별위75.0%화52.0%，IE초강조칙분별위45.0%화37.6%(P=0.064 4)。유무B증상대생존솔무현저영향（P=0.792）。Cox다인소분석현시，방료근기료효、종류초강화년령시영향예후적독립인소。결론비강IE기림파류적치료이방료위주，가상화료능제고원기생존솔。방료근기료효、림상분기화년령대예후유현저영향。
Objective　To analyze the factors affecting prognosis of patients with primary non-Hodgkin′s lymphomas (NHL) of the nasal cavity.Methods　From Jan. 1968 to Dec. 1997, a total of 71 pateitns wtih stage IE (Ann Arbor staging system, 1971) primary non-Hodgkin′s lymphomas of the nasal cavity were treated in the Tumor Hospital of Sun Yat-sen University of Medical Sciences. In 37 of the 71 patients, the lesions were limited in the nasal cavity (limited IE), and in 34, the lesions were locally extended involving the adjacent structures (extended IE) Forty-four patients were treated with radiotherapy and 27 with radiotherapy plus chemotherapy. Survival analysis was done by the Kaplan-Meier method, and multivariate analysis was carried out using Cox proportional hazard model.Results　The 5- and 10-year survival rate was 71.9% and 59.7% respectively in patients who had complete response to radiotherapy. The 5- and 10-year survival rate was both 13.9% in patients who had residual tumors after treatment. The 5- and 10- year survival rate was 69.8% and 56.7% in patients with limited IE lesions, but 40.7% and 35.6% in those with extended IE lesions. The prognosis was better in younger (<44 years) than in older patients. The 10-year survival rate of patients received radiotherapy alone and those combined with chemotherapy was 52.0% and 75.0% respectively for limited IE as compared to 37.6% and 45.0% for exstended IE. B symptoms did not significantly affect clinical outcome. Multivariate analysis showed that the immediate response to radiotherapy, invasion of the primary tumor outside of nasal cavity and patients′ age were independent prognositc factors.Conclusion　Radiotherapy is the main treatment method for stage IE non-Hodgkin′s lymphoma of the nasal cavity. Addition of chemotherapy can improve long-term survival. The local tumor response to radiotherapy, clinical staging and age of patients have significant influence on patients′ prognosis.