PVD方案同期联合调强放疗对早期结外鼻型NK／T细胞淋巴瘤的疗效  

Efficacy of PVD regimen combined with IMRT for early-stage extranodal nasal NK/T-cell lymphoma

作　　者：张盈[1] 黄韵红[1] 胡云飞[1] 刘秋琳[1] 吴涛[1] 

机构地区：[1]贵州医科大学附属肿瘤医院淋巴瘤科,贵阳550001

出　　处：《中华医学杂志》2017年第26期2047-2049,共3页National Medical Journal of China

摘　　要：目的观察培门冬酶、长春新碱、地塞米松（PVD）方案同期联合调强放疗（IMRT）对早期结外鼻型NK／T细胞淋巴瘤（ENKL）的疗效。方法收集贵州医科大学附属肿瘤医院淋巴瘤科2010年5月至2015年6月诊治的早期ENKL患者共52例，患者均接受2周期PVD方案化疗同期联合IMRT（原发肿瘤靶区：12．6—59．4Gy）放疗，并予2—4周期后续化疗。回顾性分析患者资料，观察其疗效及不良反应。结果随访截至2015年12月，52例患者中完全缓解44例（84．6％）、部分缓解7例（13．5％）。治疗期间及治疗结束后1年内因疾病进展导致死亡各1例，治疗结束后1周内因感染死亡1例，2例患者带瘤生存；客观有效率及临床缓解率均为98．1％，1、2、3年的总生存率及无进展生存率均为93．6％，1、2年的无病生存率均为90．3％；相关性分析显示放疗剂量与疗效相关（P〈0．05）。放化疗期间近期不良反应中Ⅲ级白细胞下降6例（11．5％），Ⅲ～Ⅳ级血脂异常患者5例（9．6％），m级白蛋白下降有2例（3．8％），患者均发生了不同程度的放射性口腔黏膜炎及放射性皮炎。结论PVD方案同期联合IMRT对早期ENKL疗效较好，不良反应可耐受。Objective To evaluate the efficacy of PVD chemo-regimen （Pegaspargase, vincristine and dexamethasone） combined with intensity-modulated radiotherapy （IMRT） for patients with early-stage extranodal nasal NK/T-cell lymphoma （ ENKL）. Methods Clinical data of 52 patients with early-stage ENKL were collected during May 2010 and June 2015 in Department of Lymphoma, Cancer Hospital of Guizhou Medical University, and these patients firstly received a concurrent chemoradiotherapy of two-cycle of PVD and IMRT （gross tumor volume primary： 12. 6 -59.4 Gy） and then 2 to 4 cycles of PVD as subsequent chemotherapy, the efficacy and adverse responses were retrospectively analyzed and observed. Results Follow-up stopped until December 2015, complete remission was seen in 44 cases （84. 6% ） and partial remission 7 cases （13.5%）, out of 52 cases. A total of 1 case died of progression disease during treatment and within 1 year after treatment, 1 case died of pulmonary infection within 1 week after treatment, 2 cases survived with tumor; so the objective response rate and clinical benefit rate were both 98. 1% , 1-year, 2-year and 3-year overall survival rates and progression free survival rates were all 93.6%, 1-year and 2-year disease free survival rates were both 90. 3% ; the correlation analysis showed that the radiotherapy dose was related to the curative effect （P 〈 0. 05 ）. Short term adverse responses were observed in 6 cases （11.5%） with grade 3 leucocytopenia, in 5 cases （9.6%） with grade 3 - 4 dyslipidemia and in 2 cases （ 3.8% ） with grade 3 hypoalbuminemia during chemoradiotherapy. All the patients had different degrees of radiation oral mucositis and radiation dermatitis. Conclusion For earlystage ENKL, a concurrent chemoradiotherapy of PVD regimen and IMRT have a good therapeutic effect and adverse response can be tolerated.

关 键 词：淋巴瘤 T细胞 培门冬酶 放射疗法 调强适形 治疗效果 

分 类 号：R733.1[医药卫生—肿瘤]