含门冬酰胺酶方案一线治疗结外NK/T细胞淋巴瘤疗效的多中心回顾性研究  

A multi-center retrospective study of L-asparaginase-based regimens as first-line treatment in newly diagnosed extranodal NK/T-cell lymphoma

作　　者：袁芳芳[1] 魏旭东[1] 尹青松[1] 李玉富[1] 米瑞华[1] 艾昊[1] 杨海平[1] 李红艺[1] 葛守备 刘艳艳[1] 宋永平[1] 

机构地区：[1]郑州大学附属肿瘤医院、河南省肿瘤医院、河南省血液病研究所,450008

出　　处：《中华血液学杂志》2014年第7期614-618,共5页Chinese Journal of Hematology

基　　金：国家自然科学基金（81170520、81000921）;河南省卫生厅科研课题（2011010014）

摘　　要：目的 比较以门冬酰胺酶为基础方案与CHOP方案（环磷酰胺、阿霉素、长春新碱、泼尼松）化疗联合放疗一线治疗结外NK/T细胞淋巴瘤的近期疗效、远期生存及安全性.方法 181例初诊经影像学、病理学检查确诊为结外NK/T细胞淋巴瘤患者,其中69例接受CHOP方案化疗,112例接受以门冬酰胺酶为基础方案化疗,完成2个周期以上化疗后行侵犯野放射治疗.治疗结束后评价疗效.结果 CHOP组、含门冬酰胺酶组总有效率分别为72.5％和90.2％,差异有统计学意义（P=0.002）,两组1、2、5年总生存率分别为82.6％、61.9％、28.4％和96.0％、88.3％、65.1％,两组1、2、5年无进展生存率分别为63.8％、44.0％、21.0％和94.2％、79.8％、50.0％,差异有统计学意义（P=0.000）.两组患者的主要不良反应为骨髓抑制、胃肠道反应、感染、肝功能损害等,均未出现治疗中断及相关死亡.结论 与CHOP方案相比,以门冬酰胺酶为主的联合化疗结合放疗能够显著提高结外NK/T细胞淋巴瘤患者的疗效,并改善其远期生存,安全性好.Objective To analyze the short-term efficacy,overall survival （OS）,and safety in newly diagnosed extranodal NK/T-cell lymphoma （ENKTL） patients with L-asparaginase based regimens or CHOP regimen in combination with radiotherapy as first-line treatment.Methods Of the total 181 patients diagnosed by imaging and pathology,69 patients received CHOP regimen and 112 patients received L-asparaginase based regimens.All the patients received radical radiotherapy （RT） after 6 cycles of chemotherapy.Results The overall response rates of L-asparaginase-based group and CHOP group were 90.2％ and 72.5％,respectively（P=0.002）.The 1,2,5-year OS and progression-free survival （PFS） in L-asparaginase-based group were 96.0％,88.3％,65.1％ and 94.2％,79.8％,50.0％,respectively.The 1,2,5-year OS and PFS in CHOP group were 82.6％,61.9％,28.4％ and 63.8％,44.0％,21.0％ （P=0.000）.Conclusions Compared with CHOP regimen,L-asparaginase-based chemotherapy is more effective and safe for newly diagnosed nasal-type ENKTL.

关 键 词：淋巴瘤 结外NK-T细胞 抗肿瘤联合化疗方案 门冬酰胺酶 治疗结果 

分 类 号：R733.1[医药卫生—肿瘤]