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不同的放疗模式对早期鼻腔NK/T细胞淋巴瘤预后的影响

韩宝林   

  1. 天津市宝坻区人民医院
  • 收稿日期:2011-09-02 修回日期:2011-12-24 出版日期:2012-07-15 发布日期:2012-07-15
  • 通讯作者: 韩宝林

Prognostic Effect of Different Methods of Radiotherapy to early stage Nasal NK/T Cell Lymphoma

  • Received:2011-09-02 Revised:2011-12-24 Published:2012-07-15 Online:2012-07-15

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摘要： 摘要 目的：探讨不同的放疗模式对早期鼻腔NK/T细胞淋巴瘤预后的影响。方法：回顾性分析1985年1月至2005年1月收治并接受放疗的68例早期鼻腔NK/T细胞淋巴瘤的病例资料，依放疗范围分为局部累及野27例，扩大野41例；依放疗剂量分为四组，＜45Gy组11例，45～50Gy组32例，51～60Gy组17例，＞60Gy组8例；38例行颈部预防性照射，30例未行颈部预防性照射。结果：全组局部控制率和5年总生存率分别为79.4%和52.9%。累及野放疗组和扩大野放疗组局部控制率和5年总生存率分别为66.7%、87.8%和 29.6%、68.3%（P＜0.05）。放疗剂量＜45Gy组、45～50Gy组、51～60Gy组及＞60Gy组局部控制率和5年总生存率分别为45.5%、84.4%、87.5%、88.9% 和36.4%，56.3%，56.3%，55.6%，＜45Gy组局部控制率、5年总生存率与其它三组比较有统计学意义（P＜0.05），而其它三组间比较无统计学意义（P＞0.05）。颈部预防照射组与未行颈部预防照射组比较，颈部淋巴结转移率分别为7.9%和36.7%（P＜0.05）；5年总生存率分别55.3%和50.0%（P＞0.05）。结论：扩大野和＞45Gy剂量的放疗取得了较好的局部控制率和总生存率；颈部预防照射降低了颈部淋巴结转移率，但对总生存率无影响。

关键词: 鼻腔, NK/T细胞淋巴瘤, 放射治疗, 预后

Abstract: Objective: To investigate the prognostic effect of different scopes and doses of radiotherapy and preventive neck eradiation to nasal NK/T cell lymphoma at early stage. Methods: Analyze the clinical feature of 68 patients with stage I and Ⅱ nasal NK/T cell lymphoma who received radiotherapy in our department from January 1985 to January 2005 in retrospect. According to the different scopes of radiotherapy, the patients can be divided into two groups, one group is involved field with 27 patients, another group is extended field with 41 patients. According to the different radiotherapy doses , the patients can be divided into 4 groups as less 45Gy group with 11 patients，45～50Gy group with 32 patients , 50～60Gy group with 17 patients and more than 60Gy group with 8 patients. 38 patients have received preventive neck eradiation and other 30 haven’t. Kaplan-Meier method was used to calculate the local control rate and 5-year survival rate, Log-rank test was used to inspect the significant difference. Results: The total local control rates and 5-year survival rates are 79.4% and 52.9%. The local control rates of group of involved field radiotherapy and group of extended field radiotherapy are 66.7% and 87.8%, the 5-year survival rates of these two groups are 29.6% and 68.3% (P<0.05). The local control rates of radiotherapy dose less 45Gy group, 45～50Gy group, 50～60Gy group and more than 60Gy group are 45.5%、84.4%、87.5%、88.9%（P＜0.05）, the 5-year survival rates of these groups are 36.4%，56.3%，56.3%，55.6%（P＜0.05）. Analysis on the local control rate and 5-year survival rate of the radiotherapy dose less 45Gy group have significance in statistics and the comparison among other three groups has no significance in statistics（P＞0.05）. The neck lymph node metastasis rate of the patients group who have received preventive neck eradiation and the other patients group who haven’t are 7.9% and 36.7%（P＜0.05）, 5-year survival rates of these two groups are 55.3% and 50.0% (P>0.05). Conclusion: Extended field radiotherapy at early stage has good effect for the local control rate and long term survival rate of the patients with nasal NK/T cell lymphoma. The dose of radiotherapy should be more than 40Gy. Preventive neck eradiation achieved lower neck lymph node metastasis rate but has no effect on the survival.

Key words: Nasal, NK/T cell lymphoma, Radiotherapy, Prognosis