P-Gemox方案联合调强放疗治疗早期结外NK/T细胞淋巴瘤的临床疗效  

Clinical efficacy of P-Gemox regimen combined intensity-modulated radiation therapy treatment for early-stage extranodal NK/T cell lymphoma

作　　者：权小英 吴春芝[1] 陈小艳[1] 雷蕾[1] 叶斌[1] 张智慧[2] QUAN Xiaoying;WU Chunzhi;CHEN Xiaoyan;LEI Lei;YE Bin;ZHANG Zhihui(Department of Medical Oncology,the Sixth People's Hospital of Chengdu,Chengdu 610051,China;Department of Lymphoma,Sichuan Cancer Hospital,Chengdu 610041,China)

机构地区：[1]成都市第六人民医院肿瘤科,成都610051 [2]四川省肿瘤医院淋巴瘤科,成都610041

出　　处：《中国癌症防治杂志》2020年第1期75-80,共6页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

摘　　要：目的探讨P-Gemox方案联合调强放疗治疗早期结外NK/T细胞淋巴瘤(extranodal NK/T-cell lymphoma,ENKTL)的疗效。方法回顾性分析四川省肿瘤医院2012年3月至2017年10月初治的73例ENKTL患者的临床资料,根据治疗方案分为P-Gemox方案夹心放疗组(n=38)和P-Gemox方案序贯放疗组(n=35),比较两组患者的近期和远期临床疗效。结果73例ENKTL患者总有效率(ORR)为95.9%,3年无进展生存率(PFS)为73.5%,3年总生存率(OS)为81.9%。P-Gemox方案夹心放疗组ORR为97.4%,3年PFS和OS分别为74.2%和84.1%。P-Gemox方案序贯放疗组ORR为94.3%,3年PFS和OS分别为72.6%和79.2%。两组ORR、PFS和OS差异均无统计学意义(P>0.05)。控制相关潜在混杂因素后,多因素Cox回归分析显示,P-Gemox方案夹心放疗组与P-Gemox方案序贯放疗组的PFS相当(HR=0.617,95%CI:0.353~1.081,P=0.091),而P-Gemox方案夹心放疗组较P-Gemox方案序贯放疗组OS更好(HR=0.556,95%CI:0.314~0.982,P=0.043)。两组化疗毒副反应以Ⅰ~Ⅱ级为主,其中P-Gemox方案夹心放疗组较P-Gemox方案序贯放疗组更容易发生Ⅰ~Ⅱ度转氨酶升高(P<0.05),血液学、胃肠道等毒副反应,发生率差异无统计学意义(P>0.05)。结论P-Gemox方案夹心放疗与P-Gemox方案序贯放疗的近期疗效和PFS相当,但P-Gemox方案夹心放疗较P-Gemox方案序贯放疗可提高患者OS。Objective To explore the efficacy of P-Gemox regimen combined with intensity-modulated radiotherapy for early extranodal NK/T-cell lymphoma(ENKTL). Methods The clinical data of 73 patients with ENKTL treated in Sichuan Cancer Hospital from March 2012 to October 2017 were analyzed retrospectively. According to the treatment plan,the patients were divided into P-Gemox regimen sandwich radiotherapy group(n=38) and P-Gemox sequential radiotherapy group(n=35),the short-term and long-term clinical effects of the two groups of patients were compared. Results The total effective rate(ORR) of 73 ENKTL patients was 95.9%,the 3-year progression-free survival rate(PFS)was 73.5%,and the 3-year overall survival rate(OS) was 81.9%. The ORR of the P-Gemox regimen sandwich radiotherapy group was 97.4%,and the 3-year PFS and OS were 74.2% and 84.1%,respectively.The P-Gemox regimen sequential radiotherapy group was 94.3%,and the 3-year PFS and OS were 72.6% and 79.2%. There was no significant difference in ORR,PFS,and OS between the two groups(P>0.05). After adjustment for potential confounders,multivariate Cox regression showed that the PFS of the P-Gemox regimen sandwich radiotherapy group was not inferior to the P-Gemox regimen sequential radiotherapy group(HR=0.617,95%CI:0.353-1.081,P = 0.091),while the P-Gemox regimen sandwich radiotherapy group had better OS than the patients of the P-Gemox regimen sequential radiotherapy group(HR=0.556,95%CI:0.314-0.982,P=0.043).The toxic side effects of chemotherapy in the two groups were mainly Ⅰ-Ⅱ. The P-Gemox regimen sandwich radiotherapy group was more prone to Ⅰ-Ⅱ degree transaminase elevation than the P-Gemox regimen sequential radiotherapy group(P<0.05). But other toxic side effects,such as hematology and gastrointestinal tract,were not significantly different(P>0.05). Conclusion The short-term efficacy and PFS of P-Gemox regimen sandwich radiotherapy are similar to those of P-Gemox regimen sequential radiotherapy,while the former can improve the OS of patients compared with

关 键 词：结外NK/T细胞淋巴瘤 化疗 放疗 预后 

分 类 号：R733.4[医药卫生—肿瘤]