Treatment Outcome And Prognostic Factor In Patients With Early Stage Extanodal Nasal-type Natural Killer/T-cell Lymphoma Receiving Intensity-Modulated Radiotherapy Versus Conventional Radiotherapy

Objective:To compare outcomes and prognostic factors of Early Stage Extanodal Nasal-type Natural Killer/T-cell Lymphoma treated with Intensity-Modulated Radiotherapy (IMRT) and Conventional Radiotherapy (CRT).The aim of the retrospective study is to provide some reference materials for the choice of radiotherapy styles for physicians and patients.Methods:Between January2005and March2013,a total of76patients with early stage ⅠE/ⅡE Extanodal Nasal-type Natural Killer/T-cell Lymphoma (Nasal and Waldeyer’s Ring Natural Killer/T-cell Lymphoma) were admitted to Department of Radiotherapy in XiangYa hospital. Because of the different radiotherapy styles,they were divided into two groups:the IMRT group, the CRT group. There were35persons in IMRT group and41persons in CRT group. Adopt the ways of telephones, letters, out-patient review to follow, the clinical characteristics, treatment out-comes (including survival analysis and and late radiation toxicity), and prognostic factors of the two groups were compared.Kaplan-Meier methold was applied in unifactorial analysis, and the Cox regression model was applied in multivariate analysis.Results:The CR rate of IMRT group was37.1%, CRT group was39%.No difference was found (P=0.975). The5-year-overall survival (OS) of IMRT group was62%, comparing46%of CRT group (x2=0.965,P=0.327). Statistical difference was not found in survival. The5-year-progression-free survival (PFS)of IMRT group was46%, comparing43%of CRT group (x2=1.185, P=0.276). Statistical difference was not found in survival.The OS of patient who underwent chemotherapy was44%,the opposite was56%.But statistical difference was not found in survival.The PFS of patient who underwent chemotherapy was39%,the opposite was59%.But statistical difference was not found in survival.The late toxicities of radiotherapy contains dry mouth, hearing loss, optic impairments, dysphagia, mouth-opening limitation were observed in CRT and IMRT groups. As a result, dry mouth, hearing loss, dysphagia were less in IMRT group than those in CRT group(P<0.05). But the optic impairments and mouth-opening limitation were not significantly different in both groups(P>0.05). The age and short-term curative effects were the prognostic factors of Early Stage(ⅠE/ⅡE) Nasal and Waldeyer’s Ring Natural Killer/T-cell Lymphoma(P<0.05). But gender, clinical stages, scope of the tumor, neck lymph node invasion, B symptoms, LDH in blood, choice of IMRT or CRT,IPI index, chemotherapy, were not the prognostic factors of Early Stage(ⅠE/ⅡE) Nasal and Waldeyer’s Ring Natural Killer/T-cell Lymphoma(P>0.05).Conclusion:It is uncertain that the clinical curative effects of IMRT group was better than the CRT group. Some of late toxicities were observed in the IMRT group and CRT group, the incidence rate of IMRT group was lower than CRT group. And IMRT technique was able to potentially improved the quality of daily life in patients. The age factor and the rate of CR may be the provide the reference for clinical prognosis in patients of Early Stage(ⅠE/ⅡE) Extanodal Nasal-type Natural Killer/T-cell Lymphoma...