Angiocentric T-cell and NK/T-cell lymphomas: Radiotherapeutic viewpoints
Angiocentric T-cell and NK/T-cell lymphomas: Radiotherapeutic viewpoints
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DOI：
10.1016/j.ijrobp.2003.12.006
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发表时间：
2004-07-15
影响因子：
7
通讯作者：
Kim, GE
中科院分区：
文献类型：
--
作者：
Koom, WS;Chung, EJ;Kim, GE
目的：研究单纯放疗(RT)治疗I、II期血管中心性T细胞或自然杀伤(NK)/T细胞淋巴瘤的局部失败模式和预测局部失败的危险因素，并建立影响局部控制率的剂量-反应关系。方法与材料：我们回顾了1976年至1998年间102例Ann Arbor I、II期血管中心性T细胞或NK/T细胞淋巴瘤患者的资料。分析了局部失败的模式、预测局部失败的危险因素、剂量-反应关系和生存数据。结果：尽管放疗后完全缓解率较高(72%)，但治疗失败60例，其中局部失败48例(47%)，区域性失败3例(3%)，全身性失败28例(27%)。局部失败类型：TR42例，MR 3例，ER 5例。TR/MR组的中位复发时间短于ER组(分别为1个月和12个月)。与接受ER治疗的患者相比，接受TR/MR治疗的患者预后更差(抢救治疗后的两年存活率：6%，而ER为80%；p54GY不能完全降低TR/MR的发生率，我们认为重要的是确定适当的患者亚群，增加剂量可能对他们有利。考虑到局部失败率很高，在未来的试验中，应该采用一种研究性的方法来补充RT，使用放射增敏剂或更有效的化疗药物。(C)2004年爱思唯尔公司。
Purpose: To investigate the patterns of local failure and the risk factors predictive of local failure and to establish the dose-response relationships influencing the probability of local control in patients with Stage I and II angiocentric T-cell or natural killer (NK)/T-cell lymphoma who were treated with radiotherapy (RT) alone.Methods and Materials: We retrospectively reviewed the data from 102 patients with Ann Arbor Stage I and II angiocentric T-cell or NK/T-cell lymphoma who underwent RT alone to a median dose of 45 Gy (range, 20-70 Gy) between 1976 and 1998. The patterns of local failure, risk factors predictive of local failure, dose-response relationships, and survival data were analyzed. Because of the protean feature of local recurrences, the sites of local failure were allocated to one of three categories: true recurrence (TR), marginal recurrence (MR), and elsewhere recurrence (ER).Results: Despite a higher complete remission rate (72%) after RT, 60 patients experienced treatment failure, including local failure in 48 (47%), regional failure in 3 (3%), and systemic failure in 28 (27%). The patterns of local failure were TR in 42, MR in 3, and ER in 5 patients. The median time to recurrence for TR/MR was shorter than that for ER (1 month for TR/MR vs. 12 months for ER). Patients with TR/MR had a more unfavorable prognosis than those experiencing ER (2-year survival rate after salvage treatment: 6% for TR/MR vs. 80% for ER; p54 Gy cannot entirely reduce the incidence of TR/MR, we believe it is important to identify an appropriate subset of patients for whom an additional boost dose may be beneficial. Given the high rate of local failure, an investigational approach should be conducted to supplement RT using radiosensitizers or more effective chemotherapeutic agents in future trials. (C) 2004 Elsevier Inc.