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目的:探讨Ⅰ～Ⅱ期鼻型结外NK/T细胞淋巴瘤根治性放疗的方法以及以放疗为主的综合治疗的疗效。方法:2005年9月—2009年4月连续收治的193例经病理学证实的、原发灶位于上呼吸道的Ⅰ～Ⅱ期结外NK/T细胞淋巴瘤患者,行根治性放疗,总剂量为50Gy/25次,联合或不联合以CEOP或DICE方案为主的诱导化疗。放疗范围为区域野。放疗技术采用三维适形或调强放疗。观察治疗反应率、局部和区域复发率以及生存情况。结果:全组患者的3年生存率为73.7%,3年无进展生存率为66.4%。24例接受单纯放疗患者的完全缓解率为100%。放化疗组有169例患者,其中4例因化疗中出现疾病进展而未行放疗,剩余165例接受放疗的患者中有147例达CR。3年局部控制率为90.3%。41例患者发生远处转移。多因素分析显示,原发灶累及范围与3年无进展生存期以及野内/边缘复发相关。结论:目前区域野的Ⅰ～Ⅱ期鼻型结外NK/T细胞淋巴瘤的肿瘤放疗剂量50Gy可以获得较好的反应率和较低的局部复发率。今后需要设计更有效的化疗方案以减少远处转移。
Objective: To investigate the method of radical radiotherapy of stage Ⅰ ~ Ⅱ nasal type extranodal NK / T cell lymphoma and the curative effect of radiotherapy combined therapy. METHODS: From September 2005 to April 2009, 193 patients with stage Ⅰ ~ Ⅱ extranodal NK / T cell lymphoma with pathologically confirmed primary tumors were treated with radical radiotherapy. The total dose For 50Gy / 25 times, with or without combined with CEOP or DICE program induced chemotherapy. Radiotherapy range for the regional field. Radiotherapy techniques using three-dimensional conformal or IMRT. To observe the response rate of treatment, local and regional recurrence rate and survival. Results: The 3-year overall survival rate was 73.7% in all patients and 66.4% in 3-year progression-free survival. The complete remission rate of 24 patients receiving radiotherapy alone was 100%. There were 169 patients in the radiochemotherapy group, 4 of whom had no radiotherapy due to disease progression during chemotherapy and 147 of the remaining 165 patients who received radiotherapy. 3-year local control rate of 90.3%. 41 patients with distant metastasis. Multivariate analysis showed that the extent of primary tumor involvement was related to 3-year progression-free survival and intra-field / borderline recurrence. CONCLUSION: The current regional field Ⅰ ~ Ⅱ nasal type extranodal NK / T cell lymphoma tumor radiotherapy dose 50Gy can get better response rate and lower local recurrence rate. The future need to design more effective chemotherapy to reduce the distant metastasis.