Early or up-front radiotherapy improved survival of localized extranodal NK/T-cell lymphoma, nasal-type in the upper aerodigestive tract
Early or up-front radiotherapy improved survival of localized extranodal NK/T-cell lymphoma, nasal-type in the upper aerodigestive tract
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DOI：
10.1016/j.ijrobp.2007.05.073
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发表时间：
2008-01-01
影响因子：
7
通讯作者：
Lu, You
中科院分区：
文献类型：
--
作者：
Huang, Mei-Juan;Jiang, Yu;Lu, You
目的：探讨鼻型局部结外NK/T细胞淋巴瘤早期或前期放射治疗的作用、达到合适治疗效果所需的最佳放疗剂量和预后因素。单纯化疗(CT)8例，单纯放疗(RT)9例，联合化疗(CMT)65例。在74例接受放疗的患者中，31例预先给予放疗，43例以CT为初始治疗，43例接受早期放疗。结果：5年总生存率(OS)为52.3%，无瘤生存率(DFS)为39.2%。RT是OS和DFS在单变量和多变量水平上唯一独立的预后因素。接受-54 GyRT的患者的5年OS和DFS均好于接受54 GyRT的患者(5年OS 75.5%vs.46.1%，p=0.019；5年DFS 60.3%vs.33.4%，p=0.004)。与首次放疗后早期放疗相比，早期放疗对I期患者的生存率有较好的改善(5年OS 90.0%对48.9%，p=0.012；5年DFS 78.7%对39.9%，p=0.021)。结论：鼻型结外NK/T细胞淋巴瘤早期或前期放疗对改善上呼吸道结外NK/T细胞淋巴瘤的OS和DFS具有重要作用。建议的肿瘤剂量至少为54Gy.前期放疗可能会对I期疾病患者的生存产生更多好处。(C)2008年爱思唯尔公司。
Purpose: To investigate the role of early or up-front radiotherapy (RT), the optimal RT dose required to achieve appropriate treatment outcome and prognostic factors for patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract.Methods and Materials: Eighty-two patients were reviewed. Eight patients were treated with chemotherapy (CT) alone, 9 patients received RT alone, and 65 patients were given combined modality treatment of CT and RT (CMT). Of those 74 patients receiving RT, 31 patients were given up-front RT, whereas CT was the initial therapy for 43 patients and 41 of those 43 patients received early RT.Results: Five-year overall survival (OS) and disease-free survival (DFS) were 52.3% and 39.2%, respectively. RT was the only independent prognostic factor for both OS and DFS at both the univariate and multivariate level. The 5-year OS and DFS were better in patients receiving >= 54 Gy of RT as compared with that of < 54 Gy (5-year OS 75.5% vs. 46.1%,p = 0.019; 5-year DFS 60.3% vs. 33.4%,p = 0.004). Up-front RT presented better survival in Stage I patients when compared with that of initial CT followed by early RT (5-year OS 90.0% vs. 48.9%, p = 0.012; 5-year DFS 78.7% vs. 39.9%,p = 0.021).Conclusion: Early or up-front RT had an essential role in improved OS and DFS in patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. The recommended tumor dose was at least 54 Gy. Up-front RT may yield more benefits on survival in patients with Stage I disease. (c) 2008 Elsevier Inc.