| Ji Zhou,Daiyuan Ma,Yeqin Zhou,Xianfu Li,Bangxian Tan,Mi Liu,Tao Ren. Three-dimensional conformal radiotherapy plus concurrent DICE chemotherapy for early-stage nasal-type natural killer/T-cell lymphoma of Waldeyer’s ring: A single-institution study. Oncol Transl Med, 2015, 1: 181-185. |
| 三维适形放疗联合DICE方案同步化疗韦氏环区早期鼻型NK/T细胞淋巴瘤疗效分析：单中心研究 |
| Three-dimensional conformal radiotherapy plus concurrent DICE chemotherapy for early-stage nasal-type natural killer/T-cell lymphoma of Waldeyer’s ring: A single-institution study |
| Received:January 07, 2015 Revised:July 25, 2015 |
| DOI：10.1007/s10330-015-0051-6 |
| 中文关键词: 鼻腔；NK/T细胞淋巴瘤；预后；放疗；化疗 |
| 英文关键词: nasal cavity; NK/T-cell lymphoma; prognosis; radiotherapy; chemotherapy |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Ji Zhou | the Affiliated Hospital, North Sichuan Medical College, | 41800451@qq.com | | Daiyuan Ma | the Affiliated Hospital, North Sichuan Medical College, | mdylx@163.com | | Yeqin Zhou | the Affiliated Hospital, North Sichuan Medical College, | nczyq1970@126.com | | Xianfu Li | the Affiliated Hospital, North Sichuan Medical College, | lixianfu13@163.com | | Bangxian Tan | the Affiliated Hospital, North Sichuan Medical College, | tbx_nsmc@126.com | | Mi Liu | the Affiliated Hospital, North Sichuan Medical College, | liumi212@yahoo.com.cn | | Tao Ren* | the Affiliated Hospital, North Sichuan Medical College, | 584239854@qq.com |
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| 中文摘要: |
| 目的 韦氏环鼻型NK/T细胞淋巴瘤与其他亚型具有不同的临床病理特征，其最优临床治疗方案尚不清楚。本研究旨在发现一个更加有效的联合治疗模式。方法 45例初诊初治的韦氏环NK/T细胞淋巴瘤患者随机分为同步放化疗组（23例接受三维适形放疗加同步2周期DICE方案化疗）和单纯放疗组（22例仅接受三维适形放疗）。主要研究重点为总生存率和无进展生存率，以及治疗副反应。结果 1、3、4年总生存率在同步放化疗组为100%、88.5%、88.5%单纯放疗组为95.5%、65.6%, 45.9%，同步放化疗组总生存率更好，2组之间比较有显著性差异(P=0.0477)。1、3、4年无进展生存率在同步放化疗组和单纯放疗组分别为100%、82.0%、73.8%和86.4%、56.0%、46.7%，同步组无进展生存率更好，2组之间比较有统计学意义(P=0.0488)。而总的有效率相比，同步放化疗组和单纯放疗组均为100%，但是同步组完全缓解22例，单纯放疗组为18例，但是2组之间差异无统计学意义。同步放化疗组有更严重的毒副作用，特别是3+4级白细胞减少、贫血和口腔黏膜炎。值得一提的是，良好的支持治疗使患者都能够耐受。结论 放疗加同步DICE方案化疗韦氏环区NK/T细胞淋巴瘤安全而有效。 |
| 英文摘要: |
| Objective: Nasal-type natural killer/T-cell lymphoma of Waldeyer’s ring (WR-NK/TL) has different clinicopathological characteristics from those of other subtypes of NK/T lymphoma; thus, the optimal treatment remains unclear. To find a more effective treatment model for WR-NK/TL, we conducted a single-center study of concurrent radiochemotherapy.
Methods: Forty-five patients with newly diagnosed stage IE to IIE WR-NKTL were randomly divided into two groups. The 23 cases in the concurrent radiochemotherapy group were treated with three-dimensional conformal radiotherapy (48–52 Gy) and 2 courses of DICE (dexamethasone, ifosfamide, cisplatin, and etoposide) synchronous chemotherapy. The 22 cases in the radiotherapy group only received three-dimensional conformal radiotherapy (50–54 Gy). The primary end points were overall survival (OS), progressionfree survival (PFS), and toxicity.
Results: The 1-, 3-, and 4-year OS and PFS rates were 95.5%, 65.6%, and 45.9%, and 86.4%, 56.0%, and 46.7% in the radiotherapy group, and 100%, 88.5%, and 88.5%, and 100%, 82.0%, and 73.8% in the concurrent radiochemotherapy group, respectively. The OS (P = 0.0477) and PFS rates (P = 0.0488) were higher in the concurrent radiochemotherapy group than in the radiotherapy group. The overall response rate was 100% in both the radiotherapy group [complete response (CR), 18 cases] and concurrent radiochemotherapy group (CR, 22 cases). The concurrent radiochemotherapy group had more severe side effects, especially grade 3 4 events, such as leukopenia, anorexia, and stomatitis. However, side effects benefiting from excellent oral care were endurable.
Conclusion: Radiotherapy plus concurrent DICE chemotherapy may be an effective and safe comprehensive treatment for patients with WR-NKTL. |
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