| Objective:To explore the therapeutic strategy and factors influencing prognosis through the analysis the clinical features, treatment outcomes, and prognosis of 53 patients with extranodal NK/T-cell lymphoma.Methods:A retrospective analysis of the medical records of 53 patients diagnosed with ENKTL from 2010 January to 2015 July in The Affiliated Tumor Hospital of Guangxi Medical University.The results were analyzed by the SPSS 19.0 software,and to analyze the relationship between the clinical characteristics and prognosis.Taking α=0.05 as the inspection level,Univariate analysis using Kaplan-meier and Log-rank test;Using Cox model multivariate analysis,P<0.05 showed a statistically significant difference.Result:1. The clinical characteristics of patientsA total of 53 eligible patients were enrolled. The median age was 44 years (range 22 to 69 years), the male:female ratio was 1.7:1;67.9% of the patients’ regional lymph node were involved,and involved 2 regional lymph node was common.According to Ann Arbor staging,IE and ⅡE stage patients accounted for 73.5%,IIIE and IV stage patients accounted for 26.5%;patients accompanied with B symptoms were 26 cases accounting for 49%.14 patients who more than 2 score of International prognostic index (IPI),accounting for 26.5%.Ki-67 high expression rate (no less than 50%) were 43 cases, accounting for 81%.Increased serum LDH in 24 cases,accounting for 45.3%.Decreased albumin in 24 cases,accounting for 32%,28 patients with anemia,accounting for 52.8%.Beta 2 microglobulin was tested in 36 patients,among them 20 cases increase.15 patients with local tumor invasion(bone invaded,perforation or skin invaded),accounting for 28.3%,primary in upper respiratory tract were 45 cases,primary outside of the upper respiratory tract in 8 cases.2. The treatment and prognostic analysis1,2,3 year overall survival rate of the ENKTL patients were 72%,57%, 46% respectively.The significant parameters of the univariate analysis were local tumor invasion,high IPI score (>2score), Ann Arbor stage for ⅢE or IV, LDH increased(LDH more than 240U/L).Multivatiate analysis showed that only local tumor invasion was the independent prognostic factor of poor survival.39 patients diagnosed with IE or HE ENKTL,including 10 patients in radiotherapy group,7 patients in chemotherapy group,22 patients in chemoradiotherapy group.1,2,3 years OS rate of radiotherapy group were 89%, 89% and 44% respectively.1,2,3 years OS rate of chemotherapy group were 54%,11% and 0% respectively.1,2,3 years OS rate of chemoradiotherapy group were 90%,76% and 76% respectively.14 patients diagnosed with ⅢE or IV,including 7 patients in chemotherapy group,5 patients in chemoradiotherapy group,1 patient in radiotherapy group,1 patients in give-up group. The median survival time of advanced patients were 11.7 months.,and the median survival time of the chemotherapy group and the chemoradiotherapy group were 12 months and 10 months respectively.Conclusion:1.1,2,3 year overall survival rate of the ENKTL patients were 72%,57%, 46% respectively.2. The patients diagnosed with IE or ⅡE had a better effect when adopting radiotherapy or chemoradiotherapy than pure chemotherapy.The patients diagnosed with ⅢE or IV progress fast, aggressive, had extremely bad prognosis,their treatment is given priority to with chemotherapy.But radiotherapy or chemotherapy is no effective. It is important to develop new effective treatments for these patients.3. Local tumor invasion,high IPI score, Ann Arbor stage for ⅢE or Ⅳ, LDH increased(LDH more than 240U/L) were the adverse factors of prognosis.Among them,local tumor invasion was independent risk factors for bad prognosis. |
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