CAJ | 학술논문

目的探讨ⅠE～ⅡE期原发鼻腔与原发韦氏环NK/T细胞淋巴瘤在临床特征和预后等方面的差别.方法回顾分析1991-2011年本院初治的273例患者,其中ⅠE期184例,ⅡE期89例.原发鼻腔(NC-NKTL) 209例和原发韦氏环(WR-NKTL) 64例.258例(94.5％)患者先接受化疗,多数患者接受CHOP或类似方案化疗,放疗中位剂量为54 Gy.结果与NC-NKTL相比,WR-NKTL中ⅡE期和有B症状者显著增多.两组治疗后有效率相近(88.7％和87.9％,P=0.869).随访率96.3％,随访时间满5年者196例.5年总生存率(OS)和无进展生存率(PFS)分别为52.6％和41.4％,其中NC-NKTL的5年OS有高于WR-NKTL的趋势(57.0％∶39.0％,P=0.062),而5年PFS则高于WR-NKTL的(46.7％∶25.8％,P=0.019).结论早期原发韦氏环NK/T细胞淋巴瘤较原发鼻腔病变更易发生全身症状和颈部淋巴结转移,预后较差,临床上考虑提早放疗和颈部淋巴结预防照射.
목적 탐토ⅠE～ⅡE기원발비강여원발위씨배NK/T세포림파류재림상특정화예후등방면적차별.방법 회고분석1991-2011년본원초치적273례환자,기중ⅠE기184례,ⅡE기89례.원발비강(NC-NKTL) 209례화원발위씨배(WR-NKTL) 64례.258례(94.5％)환자선접수화료,다수환자접수CHOP혹유사방안화료,방료중위제량위54 Gy.결과 여NC-NKTL상비,WR-NKTL중ⅡE기화유B증상자현저증다.량조치료후유효솔상근(88.7％화87.9％,P=0.869).수방솔96.3％,수방시간만5년자196례.5년총생존솔(OS)화무진전생존솔(PFS)분별위52.6％화41.4％,기중NC-NKTL적5년OS유고우WR-NKTL적추세(57.0％∶39.0％,P=0.062),이5년PFS칙고우WR-NKTL적(46.7％∶25.8％,P=0.019).결론 조기원발위씨배NK/T세포림파류교원발비강병변경역발생전신증상화경부림파결전이,예후교차,림상상고필제조방료화경부림파결예방조사.
Objective To investigate the differences in clinical features and prognosis between patients with stage Ⅰ E-Ⅱ E nasal cavity natural killer (NK)/T-cell lymphoma (NC-NKTL) and Waldeyer's ring NK/T-cell lymphoma (WR-NKTL).Methods A retrospective analysis was performed on 273patients with NK/T lymphoma who were initially treated in our hospital from January 1991 to December 2011.Of these patients,184 had Ann Arbor stage Ⅰ E disease,and 89 had stage Ⅱ E disease;209 had NCNKTL,and 64 had WR-NKTL.A total of 258 patients (94.5％) were first treated with chemotherapy.The majority of patients received CHOP or CHOP-like chemotherapy.The median dose of radiotherapy was 54Gy.Results Compared with NC-NKTL patients,WR-NKTL patients had significantly higher percentages of individuals in stage Ⅱ E and individuals with B symptoms (P ＜0.05 for both).The overall response rates of the two groups after treatment were similar (88.7％ vs 87.9％,P =0.869).The follow-up rate was 96.3％.196 patients were followed up for at least 5 years.The 5-year overall survival (OS) and progression-free survival (PFS) were 52.6％ and 41.4％,respectively.The 5-year OS of NC-NKTL patients was nonsignificantly higher than that of WR-NKTL patients (57.0％ vs 39.0％,P =0.062),while the 5-year PFS of NC-NKTL patients was significantly higher than that of WR-NKTL patients (46.7％ vs 25.8％,P =0.019).Conclusions Patients with early-stage WR-NKTL are more prone to systemic symptoms and cervical lymph node metastasis and have poorer prognosis,as compared with patients with early-stage NC-NKTL,so radiotherapy and prophylactic irradiation should be considered in early stage.