[Clinical characteristics and treatment of midline nasal and nasal type NK/T cell lymphoma].
OBJECTIVE
To study the clinical characteristics and treatment of midline nasal and nasal type T/Nk cell non-Hodgkin lymphoma.


METHODS
A retrospective study was made on the clinical characteristics, treatment, short-term effect, and two-year survival rate of 37 patients with midline nasal and nasal type T/NK non-Hodgkin lymphoma.


RESULTS
All of the patients were primarily treated with 2 cycles of CHOP chemotherapy. Ten of them were with good effect (common group). Then they were given 6 cycles of chemotherapy followed by focal radiotherapy and reached complete remission (CM). The other 27 patients failed to reach partial remission (PM) or even with their condition worsened after 2 cycles of CHOP regimen and were included into the refractory group. Fourteen of them received L-asparaginase-based salvage chemotherapy followed by focal radiotherapy (L-ASP group), and salvage therapy without L-ASP and followed by focal radiotherapy was given to the other 13 patients (non-L-ASP group). Continuous fever, angioinvasive growth and necrotic lesion could not be found among the patients in the common group. Their international prognostic indexes (IPI) were 0 approximately 1. Seventy percent of them were at the stages I or II. Continuous fever, angioinvasive growth and necrotic lesion could be found in the patients in refractory group. The IPIs among 85% of them were > 2, and 82% of them were at the stages III and IV. The CR rate was 46% for all patients as a whole, 100% for the common group, 26% for the refractory group (P < 0.005); and was 50% for the L-ASP group and 0% for the non-L-ASP group (P < 0.005). The 2-year survival rate was 43% for all patients as a whole, 100% for the common group, 20% for the refractory group (P < 0.005); and was 50.8% for the L-ASP group and 0% for the non-L-ASP group (P < 0.005).


CONCLUSIONS
Patients with midline nasal and nasal type T/NK non-Hodgkin lymphoma can be treated primarily by CHOP regimen and local radiotherapy. Refractory patients can be treated by salvage therapy based on L-ASP chemotherapy with a rather good effect. The clinical characteristics of most of the refractory patients include continuous fever, angioinvasive growth, necrotic lesion, being at stage III and IV, and with an IPI > 2.
Yong
W
W
Clinical Oncology School, Peking University, Beijing 100036, China.
Zheng
W
W
Zhang
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001215:Asparaginase / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D018450:Disease Progression; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000473:pathology*; D015182:Lymphatic Irradiation / Q000379:methods; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D011239:Prednisolone / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D001215:Asparaginase