鼻腔自然杀伤／T细胞淋巴瘤放射治疗的疗效和影响因素  

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

作　　者：任涛[1] 谭榜宪[1] 柳弥[1] 马代远[1] 周业琴[1] 舒晓红[1] 周芨[2] 

机构地区：[1]川北医学院附属医院肿瘤科川北医学院医学影像研究所,南充637000 [2]川北医学院附属医院耳鼻喉科,南充637000

出　　处：《白血病．淋巴瘤》2011年第3期165-167,171,共4页Journal of Leukemia & Lymphoma

基　　金：四川省卫生厅科研课题（090156）;南充市科技局应用技术研究与开发课题（2060402）

摘　　要：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CD，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（Х^2=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（Х^2=7．5266，P=0．0061）、CD3升高（Х^2=9．0912，P=0．0266）和治疗结束达到CR（Х^2=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。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（Х^2 =4.9309, P =0.0264）. Multivariate analysis confirmed that modified IPI 0-1 （Х^2 = 7.5266, P = 0.0061）, the numbers increased for CD3 （Х^2 =9.0912, P =0.0266）, and complete remission（Х^2 = 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 IPI 0-1, the number increased for CD3 and complete remission were significant favorable prognostic factors for survival.

关 键 词：鼻腔 淋巴瘤 NK/T细胞 预后 放射疗法 

分 类 号：R739.6[医药卫生—肿瘤]