CAJ | 학술논문

目的探讨放疗在ⅠE～ⅡE期结外鼻型NK/T细胞淋巴瘤综合治疗中的作用及其预后因素.方法回顾分析1990-2006年收治的177例患者,其中单纯化疗37例(中位4周期),化疗(中位3周期)+放疗(中位剂量52 Gy)128例,单纯放疗(中位剂量58 Gy)6例,放疗(中位剂量54 Gy)+化疗(中位5周期)6例.结果首程化疗后有效(CR+PR)率为65.3%,接受放疗后的为92.8%(x2=28.63,P<0.01).接受放疗的局部控制率(80.9%)优于单纯化疗者(50.0%;x2=14.39,P<0.01);5年总生存率分别为53.4%和18.3%(x2=23.38,P<0.01),无进展生存率分别为45.0%和10.9%(x2=23.46,P<0.01).首程化疗后有效与无效(SD+PD)者接受放疗的局部控制率、5年总生存率均明显优于单纯化疗者[83.5%与76.2%优于50.0%(x2=14.13,P<0.01;x2=5.78,P<0.01)、56.2%与48.6%优于18.3%(x2=28.87,P<0.05;x2=4.80,P<0.05)].结论放疗比化疗能显著提高早期结外鼻型NK/T细胞淋巴瘤的有效率、局部控制率和生存率,对化疗后局部肿瘤无效者也有显著疗效.根治性放疗应成为早期鼻型NK/T细胞淋巴瘤的首选治疗手段.
목적 탐토방료재ⅠE～ⅡE기결외비형NK/T세포림파류종합치료중적작용급기예후인소.방법 회고분석1990-2006년수치적177례환자,기중단순화료37례(중위4주기),화료(중위3주기)+방료(중위제량52 Gy)128례,단순방료(중위제량58 Gy)6례,방료(중위제량54 Gy)+화료(중위5주기)6례.결과 수정화료후유효(CR+PR)솔위65.3%,접수방료후적위92.8%(x2=28.63,P<0.01).접수방료적국부공제솔(80.9%)우우단순화료자(50.0%;x2=14.39,P<0.01);5년총생존솔분별위53.4%화18.3%(x2=23.38,P<0.01),무진전생존솔분별위45.0%화10.9%(x2=23.46,P<0.01).수정화료후유효여무효(SD+PD)자접수방료적국부공제솔、5년총생존솔균명현우우단순화료자[83.5%여76.2%우우50.0%(x2=14.13,P<0.01;x2=5.78,P<0.01)、56.2%여48.6%우우18.3%(x2=28.87,P<0.05;x2=4.80,P<0.05)].결론 방료비화료능현저제고조기결외비형NK/T세포림파류적유효솔、국부공제솔화생존솔,대화료후국부종류무효자야유현저료효.근치성방료응성위조기비형NK/T세포림파류적수선치료수단.
Objective To investigate the role of radiotherapy (RT) and prognostic factors in the combined modality treatment (CMT) of patients with stage ⅠE-ⅡE extranodal nasal type NK/T-cell lym-phoma. Methods From Dec. 1990 to Dec. 2006,177 patients who were diagnosed and treated in our hos-pital were retrospectively analyzed,induding 37 received chemotherapy (CT) alone ( median 4 cycles), 128 received CT (median 3 cycles) followed by RT (median 52 Gy) ,6 received RT alone (median 58 Gy) and 6 received RT ( median 54 Gy) followed by CT ( median 5 cycles). Results The overall response ( CR + PR) rate after initial CT was 60.8% compared with 83.8% after RT ( x2 = 28.63, P < 0.01 ). The 5-year overall survival (OS) and progress-free survival (PFS) rates were 46.2% and 36.8% ,respectively. The lo-cal control rates were 80.9% for RT ( alone or with CMT) and 50.0% for CT alone (x2 = 14.39, P < 0.01 ), and corresponding 5-year OS and PFS were 53.4% vs. 18.3 % ( x2 = 23.38, P < 0.01 ) and 45.0% vs. 10.9% (x2 =23.46,P <0.01 ),respectively. Compared with CT alone,the following definitive RT for patients who achieved response or not after initial CT significantly improved the local control [83.5%, 76.2% vs. 50.0% (x2 = 14.13,P <0.01;x2 =5.78,P <0.01)] and 5-year OS[56.2%,48.6% vs. 18.3%(x2 =28.87,P <0. 05;x2 =4.80,P <0.05)]. Concinsions Compared with CT alone, RT a-chieves better tumor response, local control and survival of patients not only with tumor response but also with local progression after CT. Definitive RT should be the reasonable choice of treatment for early stage extran-odal nasal type NK/T-cell lymphoma.