Treatment Outcome and Prognostic Factors of NK/T-Cell Lymphoma of the Nasal Cavity and Paranasal Sinuses

鼻腔及鼻竇NK/T細胞淋巴瘤之治療結果與預後因子分析

周采薇(Tsai-Wei Chou) ； 劉幕台(Mu-Tai Liu) ； 畢祖平(Chu-Ping Pi) ； 張東浩(Tung-Hao Chang) ； 黃昭源(Chao-Yuan Huang) ； 黃家俊(Chia-Chun Huang)

《放射治療與腫瘤學》 17卷4期 (2010/12) Pp. 279-291

https://doi.org/10.6316/TRO/201017(4)279

摘要

Purpose: The purpose of this study is to evaluate the overall survival of patients with NK/T-cell lymphoma arising from the nasal cavity and paranasal sinus, and to identify prognostic factors that affect clinical outcome.
Materials and Methods: The records of 18 patients with primary sinonasal NK/T-cell lymphoma diagnosed and treated in our institution between September 1992 and September 2008 were reviewed. Twelve patients were male, and 6 patients were female. The median age of the patients at the diagnosis was 52 years old (range 28-75 years old). Fourteen patients had loco-regional disease (stage Ⅰ-Ⅱ) and 4 patients had systemic disease (stage Ⅲ-Ⅳ). A total of 5 patients received chemo therapy (C/T) only, 1 patient received radiotherapy (RT) only, and 12 patients received combination of RT and C/T.
Results: The median follow up period was 44 months (range from 0.4 months to 16.0 years). Twelve patients (66.7%) achieved complete response (CR) by image study, and then 6 out of the 12 patients had recurrent disease. The 5-year overall survival and 2-year disease-free survival (DFS) rate were 55.2% and 42.2%, respectively. Up front RT resulted in better DFS for 14 patients with stage Ⅰ/Ⅱ disease (2-year DFS: RT vs. C/T: 83.3% vs. 25%, P=0.031). CR was the most potent prognostic factor affecting 5-year overall survival (CR vs. non-CR: 83.3% vs. 0%, P＜0.001) and 2-year DFS (CR vs. non-CR: 48.1% vs. 0%, P＜0.001). The International Prognostic Index score was found to independently influence only the DFS in patients with NK/T-cell lymphoma.
Conclusion: In this study, achievement of a CR is a particularly important determinant of treatment success. In analysis the 14 patients with stage Ⅰ/Ⅱ disease, up front RT had an essential role improvement of DFS.

關鍵字

NK/T細胞淋巴瘤 ； 鼻腔 ； 鼻竇 ； 預後因子

並列摘要

Purpose: The purpose of this study is to evaluate the overall survival of patients with NK/T-cell lymphoma arising from the nasal cavity and paranasal sinus, and to identify prognostic factors that affect clinical outcome.
Materials and Methods: The records of 18 patients with primary sinonasal NK/T-cell lymphoma diagnosed and treated in our institution between September 1992 and September 2008 were reviewed. Twelve patients were male, and 6 patients were female. The median age of the patients at the diagnosis was 52 years old (range 28-75 years old). Fourteen patients had loco-regional disease (stage Ⅰ-Ⅱ) and 4 patients had systemic disease (stage Ⅲ-Ⅳ). A total of 5 patients received chemo therapy (C/T) only, 1 patient received radiotherapy (RT) only, and 12 patients received combination of RT and C/T.
Results: The median follow up period was 44 months (range from 0.4 months to 16.0 years). Twelve patients (66.7%) achieved complete response (CR) by image study, and then 6 out of the 12 patients had recurrent disease. The 5-year overall survival and 2-year disease-free survival (DFS) rate were 55.2% and 42.2%, respectively. Up front RT resulted in better DFS for 14 patients with stage Ⅰ/Ⅱ disease (2-year DFS: RT vs. C/T: 83.3% vs. 25%, P=0.031). CR was the most potent prognostic factor affecting 5-year overall survival (CR vs. non-CR: 83.3% vs. 0%, P＜0.001) and 2-year DFS (CR vs. non-CR: 48.1% vs. 0%, P＜0.001). The International Prognostic Index score was found to independently influence only the DFS in patients with NK/T-cell lymphoma.
Conclusion: In this study, achievement of a CR is a particularly important determinant of treatment success. In analysis the 14 patients with stage Ⅰ/Ⅱ disease, up front RT had an essential role improvement of DFS.

並列關鍵字

NK/T-cell lymphoma ； Nasal cavity ； Paranasal sinus ； Prognostic factors