摘要目的 观察鼻腔、韦氏环NK/T细胞淋巴瘤放化疗疗效,并分析影响预后的因素.方法 2000-2010年本院共收治经免疫组化确诊130例鼻腔、韦氏环NK/T细胞淋巴瘤,其中鼻腔的109例、韦氏环的21例.Ann Arbor分期ⅠE期116例、ⅡE期14例.单纯放疗30例,单纯化疗2例,放化疗联合98例.结果 随访率100％,随访时间满5年者78例.完全缓解率全组为89.2％,ⅠE、ⅡE期的分别为88.8％、92.9％(x2=0.02,P=0.837),单纯放疗、放化疗联合的分别为86％、96％ (x2=1.44,P=0.230).全组5年总生存(OS)和无瘤生存(DFS)率分别为58.0％和57.2％,ⅠE、ⅡE期患者5年OS分别为60.6％、36.3％ (x2 =0.25,P=0.615),5年DFS分别为59.7％、36.3％(x2=0.21,P=0.648)；单纯放疗、放化联合的5年OS分别为70％、48％(x2 =0.01,P=0.933),5年DFS分别为66％和48％(x2 =0.09,P=0.764).单纯放疗、放化联合的主要3、4级不良反应总发生率分别为6.7％、54.1％(x2=41.38,P=0.002).原发灶照射剂量(x2=3.18,P=0.005)、ECOG评分(x2=2.97,P=0.008)与OS相关.结论 ⅠE、ⅡE期鼻腔、韦氏环NK/T细胞淋巴瘤放化联合与单纯放疗疗效相似,但不良反应较重；原发灶照射剂量、ECOG评分是影响OS的因素.

abstractsObjective To observe the clinical effects of radiotherapy and/or chemotherapy in the treatment of nasal and Waldeyer ring natural killer (NK)/T cell lymphoma and to analyze the prognostic factors.Methods Between January 20,2000 and December 21,2010,109 patients with nasal NK/T cell lymphoma and 21 patients with Waldeyer ring NK/T cell lymphoma were admitted to our hospital; the diagnosis was confirmed by immunohistochemistry.According to the Ann Arbor staging system,116 patients were classified as stage Ⅰ E,and 14 as stage Ⅱ E.Thirty patients received radiotherapy alone;2 patients received chemotherapy alone; 98 patients received radiochemotherapy.Results The follow-up rate was 100％.Seventy-eight patients were followed up for at least 5 years.The complete remission (CR) rate was 89.2％ in all patients.The CR rates of stage Ⅰ E patients and stage Ⅱ E patients were 88.8％ and 92.9％,respectively (x2 =0.02,P =0.837).The CR rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 86％ and 96％,respectively (x2 =1.44,P =0.230).The five-year overall survival (OS) rate and disease-free survival (DFS) rate of all patients were 58.0％ and 57.2％,respectively.The five-year OS rates of stage Ⅰ E patients and stage Ⅱ E patients were 60.6％ and 36.3％,respectively (x2 =0.25,P =0.615) ;the five-year DFS rates of stage Ⅰ E patients and stage Ⅱ E patients were 59.7％ and 36.3％,respectively (x2 =0.21,P =0.648).The five-year OS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 70.0％ and 48.4％,respectively (x2 =0.01,P =0.933) ; the five-year DFS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 65.6％ and 48.4％,respectively (x2 =0.09,P =0.764).The grade 3-4 toxicity rates of radiotherapy alone and radiochemotherapy were 6.7％ and 54.1％,respectively (x2 =41.38,P=0.002).The radiation dose to the primary lesion and Eastern Cooperative Oncology Group (ECOG) score were correlated with OS (x2 =3.1 8,P =0.005 ; x2 =2.97,P =0.008).Conclusions The clinical effect of radiochemotherapy is similar to that of radiotherapy alone in the patients with stage ⅠE and ⅡE nasal and Waldeyer ring NK/T cell lymphoma,but radiochemotherapy has higher toxicity than radiotherapy alone.The radiation dose to the primary lesion and ECOG score are the influential factors for OS.