摘要目的 观察培门冬酶、长春新碱、地塞米松(PVD)方案同期联合调强放疗(IMRT)对早期结外鼻型NK/T细胞淋巴瘤(ENKL)的疗效.方法 收集贵州医科大学附属肿瘤医院淋巴瘤科2010年5月至2015年6月诊治的早期ENKL患者共52例,患者均接受2周期PVD方案化疗同期联合IMRT(原发肿瘤靶区:12.6 ～59.4 Gy)放疗,并予2～4周期后续化疗.回顾性分析患者资料,观察其疗效及不良反应.结果 随访截至2015年12月,52例患者中完全缓解44例(84.6％)、部分缓解7例(13.5％).治疗期间及治疗结束后1年内因疾病进展导致死亡各1例,治疗结束后1周内因感染死亡1例,2例患者带瘤生存;客观有效率及临床缓解率均为98.1％,1、2、3年的总生存率及无进展生存率均为93.6％,1、2年的无病生存率均为90.3％;相关性分析显示放疗剂量与疗效相关(P＜0.05).放化疗期间近期不良反应中Ⅲ级白细胞下降6例(11.5％),Ⅲ～Ⅳ级血脂异常患者5例(9.6％),Ⅲ级白蛋白下降有2例(3.8％),患者均发生了不同程度的放射性口腔黏膜炎及放射性皮炎.结论 PVD方案同期联合IMRT对早期ENKL疗效较好,不良反应可耐受.

abstractsObjective To evaluate the efficacy of PVD chemo-regimen (Pegaspargase,vincristine and dexamethasone) combined with intensity-modulated radiotherapy (IMRT) for patients with early-stage extranodal nasal NK/T-cell lymphoma (ENKL).Methods Clinical data of 52 patients with early-stage ENKL were collected during May 2010 and June 2015 in Department of Lymphoma,Cancer Hospital of Guizhou Medical University,and these patients firstly received a concurrent chemoradiotherapy of two-cycle of PVD and IMRT (gross tumor volume primary:12.6-59.4 Gy) and then 2 to 4 cycles of PVD as subsequent chemotherapy,the efficacy and adverse responses were retrospectively analyzed and observed.Results Follow-up stopped until December 2015,complete remission was seen in 44 cases (84.6％) and partial remission 7 cases (13.5％),out of 52 cases.A total of 1 case died of progression disease during treatment and within 1 year after treatment,1 case died of pulmonary infection within 1 week after treatment,2 cases survived with tumor;so the objective response rate and clinical benefit rate were both 98.1％,1-year,2-year and 3-year overall survival rates and progression free survival rates were all 93.6％,1-year and 2-year disease free survival rates were both 90.3％;the correlation analysis showed that the radiotherapy dose was related to the curative effect (P ＜ 0.05).Short term adverse responses were observed in 6 cases (11.5％) with grade 3 leucocytopenia,in 5 cases (9.6％) with grade 3-4 dyslipidemia and in 2 cases (3.8％) with grade 3 hypoalbuminemia during chemoradiotherapy.All the patients had different degrees of radiation oral mucositis and radiation dermatitis.Conclusion For earlystage ENKL,a concurrent chemoradiotherapy of PVD regimen and IMRT have a good therapeutic effect and adverse response can be tolerated.