Treatment And Prognostic Analysis Of Nasal Non-Hogkin's Lymophoma

Objects: To investigate the clinical characteristics and prognostic factors of 135nasal non-Hodgkin's lymphoma patients, and search for a new direction for bettertherapy outcome.Methods: 135 patients of nasal non-Hodgkin's lymphoma were treated fromJanuary 1980 to December 2000 in Tianjin cancer hospital. According to the AnnArbor Sta- ging System,60 patients had stageⅠ,46 stageⅡ,15 stageⅢand 14 stageⅣdisease. Among the 135 patients, 27 patients received radiotherapy alone, 21chemotherapy alone, 81 chemotherapy plus radiotherapy,and 6 autologousperipheral blood stem cell transplantation(APBSCT)combined with total bodyirradiation(TBI). There are 108 patients that received radiotherapy, according to thedifferent 1 radiotherapy dose, we divided them into 4 groups: 21 in less 45 Gy group, 40 in 45-50Gy group, 30 in 50-60 Gy group andl7 in more than 60 Gy group. Depended on whether receivingthe preventive neck irradiation or not,we also divided the patients into two groups, 55 patientsreceived preventive neck irradiation and 53 patients without preventive neck irradiation. Weobserved the local control rate and 5-year survival rate, statistics with the SPSS method,review analysis the prognostic factors.Results: The local control rate and 5-year survival rate of the four groups of purechemotherapy, pure radiotherapy, combined chemotherapy and radiotherapy andAPBSCTcombinedTBIwere 12%, 69%, 76%, 83% and. 9%, 52%, 63%, 76%.For the four groups,.the best is APBSCT, then combined chemotherapy andradiotherapy group,then pure radiotherapy, the last is pure chemotherapy. There issignificant difference between four groups (P＜0.05). The local control rate and5-year survival rate in less 45 Gy group are lower than the other three groups, Thereis significant difference between four groups (P＜0.05). The patients received preventiveneck irradiation achieved lower neck lymph node matastasis rate than the group without preventive neck irradiation but there are no significant difference in the survival rate in the twogroups. Single factor analyses showeded that Ann Arbor Staging, tumor extension, IPIadjusted by staging, treatment method, and radiotherapy dose were prognostic factorsfor 5-year survival rate but gender, age, pathology, LDH, B symptoms and preventiveneck iradiation had little effect on prognostic; finally multi-factor analyses showed thatAnn Arbor Staging, tumor extension, IPI adjusted by staging, treatment method werethe most important prognostic factors for 5-year survival rate.Conclusions: Radiotherapy is suggested as the primary treatment for early stagenasal lymphoma. Chemotherapy plus radiotherapy group achieves a better survivalrate than radiotherapy only, pure chemotherapy achieves a poor survival rate, itsuggested that pure chemotherapy should not be used only. The survival rate ofchemotherapy and radiotherapy are not better in advanced nasal NK/T cell lymphomatoo, we shoud find more effect method. The radiotherapy dose in nasal non-Hodgkin'slymphoma should be more than 45 Gy. Preventive neck iradiation has no effect on thesurvival. APBSCT combined TBI achieved better effect...