肿瘤预防与治疗2019，Vol.32Issue(1)：43-53,11.DOI:10. 3969／j. issn. 1674-0904. 2019. 01. 007
不同治疗模式治疗早期结外NK/T细胞淋巴瘤的疗效对比
Efficacy of Different Treatments for Early Stage Extranodal Natural Killer/T-cell Lymphoma
摘要
Abstract
Objective: To compare the efficacy of different treatments for early stage extranodal natural killer／T-cell lym-phoma (ENKTL). Methods: In total, 132 patients with early stage ENKTL treated in Sichuan Cancer Hospital from June 2009 to September 2017 were enrolled to compare the efficacy of P-Gemox sandwich radiotherapy(group A), P-Gemox se-quential radiotherapy(group B), and radiotherapy alone(group C), and explore the prognostic factors. Results: For the 49 patients in group A, complete response ( CR), partial response ( PR), overall response rate (ORR), 3-year progression free survival (PFS), and 3-year overall survival (OS) were 89. 8% , 6. 1% , 95. 9% , 68. 8% , and 78. 7% , respectively. For the 42 patients in group B, CR, PR, ORR, 3-year PFS, and 3-year OS were 85. 7% , 9. 5% , 95. 2% , 67. 4% , and 76. 9% , respectively. As for the 41 patients in group C, CR, PR, ORR, 3-year PFS, and 3-year OS were 61. 0% , 19. 5% , 80. 5% , 40. 3% , and 44. 3% , respectively. According to the Bonferroni test, there were statistically significant differ-ences between group A and group C in CR, PFS and OS (P<0. 05). There was statistically significant difference between group B and group C in CR (P<0. 05), but differences in PFS and OS were not statistically significant (P>0. 05). Mean-while, there were no statistically significant differences between group A and group B in CR, PFS and OS (P>0. 05). Ma-jor side effects of chemotherapy included bone marrow suppression and abnormal liver function, and there were no statistically significant differences between group A and group B in side effects (P>0. 05). Major side effects of radiotherapy included bone marrow suppression, radiation mucositis and radiodermatitis. There were statistically significant differences between group A and group C in I~II° anemia and I~II° radiodermatitis (P<0. 05). There was statistically significant difference between group B and group C in I~II° anemia (P<0. 05), and differences in other adverse reactions were not statistically significant (P>0. 05). Univariate analysis showed that ECOG, LDH, B symptoms, clinical stage, local tumor invasion, treatment mode were correlated with PFS (P<0. 05). ECOG, LDH, B symptoms, clinical stage, age, PINK score, local tumor invasion, treatment mode were related to OS (P<0. 05). Multivariate analysis showed that ECOG and LDH were in-dependent prognostic factors (P<0. 05). Conclusion: The efficacy of P-Gemox sandwich radiotherapy is not inferior to P-Gemox sequential radiotherapy for early stage ENKTL patients. P-Gemox combined with radiotherapy improves the efficacy and prognosis compared to radiotherapy alone. ECOG and LDH are independent prognostic factors.关键词
培门冬酶/结外NK／T淋巴瘤/预后Key words
Pegaspargase/ Natural killer／T-cell lymphoma/ Prognosis分类
医药卫生引用本文复制引用
Quan Xiaoying,Lei Lei,Wang Pinjia,Chen Xiaoyan,Wu Chunzhi,Ye Bin,Feng Weizhen,Ouyang Chutong,Zhang Zhihui..不同治疗模式治疗早期结外NK/T细胞淋巴瘤的疗效对比[J].肿瘤预防与治疗,2019,32(1):43-53,11.基金项目
四川省卫生厅科学研究项目(编号:090528) This study was supported by grants from Sichuan Provincial Health Department (NO. 090528) （编号:090528）
