Clinical Analysis Of Nasal NK / T-cell Lymphoma

Objective: To retrospectively analyze the clinical data of nasal NK / T-cell lymphoma and investigate its clinical feature, treatment pattern and prognosis.Methods: Collecting 37 cases of primary nasal NK / T-cell lymphoma treated in Fujian Medical University Union Hospital from November 2007 to April 2014. Acording to the Ann Arbor staging classification, there were 19 stage I,9 stage II,6 stage III and 3 stage IV.20 cases received radiochemotherapy,11 chemotherapy alone and 6 radiotherapy alone. Of the patients, 12 patients received combination of surgery and radiochemotherapy(8 stage I,1 stage II,2 stage III and 1 stage IV, 9 cases received surgery and radiochemotherapy,3 cases received surgery and chemotherapy alone, the main chemotherapy are CHOP, CEOP and SMILE program).Results: The term curative effect analysis showed that patients received radiochemotherapy accounted for 54.1%(20/37) and 18 cases of them obtained CR or PR, accounting for 90%(18/20). Receiving chemotherapy alone accounted for 29.7%(11/37), and 5 cases of them obtained CR or PR, accounting for 45.5%(5/11). The others receiving radiotherapy alone accounted for only 16.2%(6/37), and 6 cases of them obtained CR or PR, accounting for 100%(6/6),and they are all the Ann Arbor stage I patients. There are significant differences between the three group(P = 0.006). Survival analysis showed that 11 of the follow-up 37 cases died. Using the kaplanmeier survival analysis method calculated the overall survival rate of patients, the average survival time in the study was 63.8 months, 95% CI of the survival time was 51.9 to 75.7months. 1-year and 3-year overall survival were 77.5% and 72.0%.The OS of stage I / II and stage III / IV were 84.5% and 54.2%.Univariate survival analysis used the Log-Rank test for overall survival of all patients analysis, α = 0.05. The results suggest that local invasion, Ann Arbor stage, presence or B symptoms, extraluminal invasion, PS score, hemoglobin, IPI score, primary treatment effect, treatment patterns of patients affected the prognosis when gender, Age, LDH, albumin, surgery These did not affect the patients’ prognosis. Multivariate Cox regression model analysis showed that only PS score and primary treatment effect were independent prognostic factors of nasal NK / T-cell lymphoma.Conclusion: 1. Prognostic factors include local invasion, Ann Arbor stage, B symptoms, extraluminal invasion, PS score, hemoglobin, IPI score, primary treatment effect, treatment patterns.Only PS score and primary treatment effect are independent prognostic factors.the higher PS score and poorer primary treatment effect of one patient, the shorter lifetime and the worse the prognosis one will have. 2. For patients with early stage,there were not significant difference in the efficacy between radiotherapy alone and radiochemotherapy.But radiotherapy alone and radiochemotherapy are significantly better than chemotherapy alone in short-term effect and long-term survival,suggesting that radiotherapy plays an important role in therapeutic effect in patients with early stage. 3. For patients who are relapsed and refractory,combined chemotherapy containing LASP or gemcitabine is recommended. 4. Surgery may have a positive short-term effect in early cases,but complete resection of localized disease on impact of the disease prognosis deserves further exploration.