CHOP followed by involved field radiation: Is it optimal for localized nasal natural killer/T-cell lymphoma?
CHOP followed by involved field radiation: Is it optimal for localized nasal natural killer/T-cell lymphoma?
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DOI：
10.1023/a:1011144911781
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发表时间：
2001-03-01
影响因子：
50.5
通讯作者：
Park, K
中科院分区：
文献类型：
--
作者：
Kim, WS;Song, SY;Park, K
本研究旨在分析四个周期的 CHOP（环磷酰胺-长春新碱-多柔比星-泼尼松龙）联合受累场放射治疗（IF RT）治疗 I-II 期鼻自然杀伤（NK）/T 细胞淋巴瘤的治疗结果。从 1995 年 3 月到 1999 年 12 月，17 名患有局限性鼻腔疾病的患者（中位年龄 41 岁；范围 30-66） NK/T 细胞淋巴瘤患者入组。 5 名患者 (31%) 出现 B 症状。根据国际预后指数 (IPI) 分类，17 名患者中有 16 名 (94%) 属于低风险。治疗计划包括四个周期的 CHOP 化疗，然后是 45 Gy 的 IF RT。两名患者因原发肿瘤部位出血而在第一或第二周期 CHOP 期间接受了放射治疗。两名患者均获得完全缓解 (CR)。其余 15 名患者在 4 个周期的 CHOP 后，获得 6 例 CR 和 3 例部分缓解 (PR)（缓解率 53%）。 6 名患者接受了 IF RT（4 名 CR、1 名 PR、1 名 PD），所有 6 名患者均达到 CR。总体而言，17 名患者中有 10 名获得 CR（58%）。由于化疗期间病情进展，17 名患者中只有 6 名 (35%) 完成了计划的序贯放化疗。获得 CR 的患者在随访期间均未出现淋巴瘤复发。估计总体三年生存率为 59%。在单变量分析中，B症状和分期是缓解和总生存的重要预后因素（P < 0.05）。本研究表明，四个周期的CHOP随后IF RT对于治疗局限性鼻NK/T细胞淋巴瘤患者的效果并不令人满意，需要进一步探索改进的治疗方法。
The present study aimed to analyse the treatment outcome of four cycles of CHOP (cyclophosphamide-vincristine-doxorubicin-prednisolone) followed by involved field radiation therapy (IF RT) for the treatment of stage I-II nasal natural killer (NK)/T-cell lymphoma.From March 1995 to December 1999, 17 patients (median age 41 years; range 30-66) with localized nasal NK/T-cell lymphoma were enrolled. B symptoms were noted in five patients (31%). Sixteen of seventeen patients (94%) were of low risk when classified according to the International Prognostic Index (IPI).The treatment plan consisted of four cycles of CHOP chemotherapy followed by IF RT of 45 Gy. Two patients received radiation during the first or second cycle of CHOP because of bleeding from the primary tumour site. Both patients achieved complete responses (CRs). In the remaining 15 patients, after 4 cycles of CHOP, 6 CRs and 3 partial responses (PRs) were achieved (53% of response rate). IF RT was given to six patients (four in CR, one in PR and one in PD), and all six patients achieved CR. Overall, CR was achieved in 10 of 17 patients (58%). The planned sequential chemoradiotherapy was completed in only 6 of 17 patients (35%) because of the progression during chemotherapy. None of the patients who achieved CR experienced relapse of lymphoma during follow-up. The estimated overall three-year survival rate was 59%. In univariate analysis, B symptoms and stage were significant prognostic factors for response and overall survival (P < 0.05).The present study suggests that four cycles of CHOP followed by IF RT is not satisfactory for treating patients with localized nasal NK/T-cell lymphoma, and that further exploration for improved therapy is needed.