调强放射治疗联合培门冬酶/左旋门冬酰胺酶为基础的化疗方案治疗结外鼻腔NKT细胞淋巴瘤的临床效果  

Intensity Modulated Radiation Therapy Combined with Pegaspargase/L-asparaginase-Based Chemotherapy in the Treatment of Extranodal Nasal-type NKT Cell Lymphoma

作　　者：巴云涛[1] 刘海龙[1] BA Yuntao;LIU Hailong(He'nan Cancer Hospital,Zhengzhou,466000)

机构地区：[1]河南省肿瘤医院,466000

出　　处：《实用癌症杂志》2019年第2期335-338,共4页The Practical Journal of Cancer

摘　　要：目的探讨IMRT(静态调强放射)联合培门冬酰胺酶为基础的化疗治疗结外鼻腔NKT细胞淋巴瘤的临床效果。方法回顾性分析68例结外鼻腔NKT细胞淋巴瘤患者的临床资料,其中22例予以常规化疗(12例予以冬酰胺酶/左旋门冬酰胺酶+GEMOX方案,10例予以培门冬酰胺酶/左旋门冬酰胺酶+DICE方案),纳入对照组; 46例行IMRT(静态调强放射)联合培门冬酰胺酶为基础的化疗,纳入观察组,并将观察组根据治疗基础不同分2组,观察1组24例行冬酰胺酶/左旋门冬酰胺酶+GEMOX方案化疗+IMRT;观察2组22例行培门冬酰胺酶/左旋门冬酰胺酶+DICE方案+IMRT)。结果观察组治疗后3个月缓解率为91. 30%,高于对照组68. 18%,组间差异有统计学意义(P <0. 05)。观察组和对照组化疗不良反应无统计学差异(P> 0. 05);而观察1组神经毒性发生率较观察2组高(39. 13%vs9. 09%),观察2组骨髓抑制Ⅲ~Ⅳ级及恶性、呕吐发生率分别为27. 27%、0. 91%,高于观察1组的4. 17%和58. 33%,组间统计差异有统计学意义(P <0. 05);观察1组和观察2组急性、慢性放射性不良反应均无统计学差异(P均> 0. 05)。观察组5年生存率明显较对照组高(73. 91%vs36. 36%),组间差异有统计学意义(P <0. 05)。结论 IMRT(静态调强放射)联合培门冬酰胺酶为基础的化疗治疗结外鼻腔NKT细胞淋巴瘤疗效确切,可提高患者5年生存率,对于改善患者预后有积极作用。冬酰胺酶/左旋门冬酰胺酶+GEMOX方案化疗+IMRT治疗安全性更高,可供临床参考。Objective To investigate the clinical efficacy of intensity modulated radiation therapy(IMRT)combined with pegaspargase-based chemotherapy in the treatment of extranodal nasal-type NK/T-cell lymphoma(ENKTL).Methods The clinical data of 68 cases of ENKTL were retrospectively analyzed.Patients were divided into two groups according to the different treatment methods;Control group(n=22)received the pegaspargase-based chemotherapy,including 12 cases receiving Asparaginase/L-asparaginase+GEMOX chemotherapy,and 10 cases receiving Pegaspargase/L-asparagine Enzyme+DICE chemotherapy;Observation group(n=46)was treated with IMRT combined with pegaspargase-based chemotherapy,then the observation group was further divided into two subgroups,namely,first subgroup(n=24)receiving pegaspargase/L-asparaginase+GEMOX chemotherapy+IMRT,and second subgroup(n=22)receiving Pegaspargase/L-asparagine Enzyme+DICE chemotherapy+IMRT.Results The remission rate of the observation group was higher than that of the control group at the post-treatment 3mon(91.30%vs 68.18%,P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P >0.05);The incidence of neurotoxicity in first subgroup was significantly higher than that in second subgroup(39.13%vs 9.09%);The incidence of gradeⅢ~Ⅳbone marrow suppression and vomiting in second subgroup was higher than that of in the first subgroup(27.27%vs 4.17%;0.91%vs 58.33%,P<0.05).There was no significant difference in acute and chronic radioactive adverse reactions between first and second subgroups(P >0.05).The 5-year survival rate of the observation group was significantly higher than that of the control group(73.91%vs 36.36%,P<0.05).Conclusion The application of pegaspargase/L-asparaginase+GEMOX chemotherapy+IMRT can effectively and safely ameliorate the 5-year survival rate and prognosis of ENKTL patients,which has certain value for clinical application.

关 键 词：结外鼻腔NKT细胞淋巴瘤 静态调强放射 培门冬酰胺酶 临床效果 

分 类 号：R730.55[医药卫生—肿瘤]