[Prognostic factors of primary non-Hodgkin's lymphoma of the nasal cavity--a report of 129 cases].
OBJECTIVE
The prognosis of primary non-Hodgkin's lymphoma (NHL) of the nasal cavity was poor, and the distant metastasis and local relapse rates are high. This study was to analyze the prognostic factors of this disease.


METHODS
Clinical data of 129 patients with pathologically confirmed nasal NHL, treated from Jan. 1996 to Dec. 2002, were retrospectively reviewed. Of the 129 patients, 116 were diagnosed as nasal NK/T-cell lymphoma. According to the Ann Arbor staging system, 102 patients had stage IE disease, 22 stage IIE, and 5 stage IVE. Among the 124 patients with stage IE or IIE disease, 22 received radiotherapy alone, 7 received chemotherapy alone, and 95 received combined modality therapy (CMT). Of the patients received CMT, 45 received radiotherapy followed by chemotherapy, and 50 received chemotherapy followed by radiotherapy. The stage IVE patients received chemotherapy with or without radiotherapy.


RESULTS
The 5-year overall survival (OS) and disease-freely survival (DFS) rates for all patients were 68.0% and 55.8%, respectively. The 5-year OS and DFS rates were 71.7% and 60.9% for stage IE patients, and 70.6% and 47.0% for stage IIE patients, respectively (P>0.05). The 5-year OS and DFS rates were significantly higher in the patients who achieved complete response (CR) than in those who didn't (83.1% vs. 18.0%, 68.0% vs. 15.5%, P<0.01). The 5-year OS rates of the patients with international prognostic index (IPI) score of 0, 1, and > or =2 were 81.1%, 60.1%, and 14.3% (P<0.01), respectively; the 5-year DFS rates were 68.8%, 44.6%, and 22.5% (P<0.01), respectively. Thirty-eight patients developed progression or relapse, with distant extranodal dissemination (78.9%) as the primary pattern of failure. Univariate analysis showed that CR rate, PS, IPI, and modified IPI were related to prognosis. Multivariate analysis showed that CR rate was an independent prognostic factor.


CONCLUSIONS
CR rate after treatment is an important prognostic factor of nasal NHL. Distant metastasis is the main failure pattern of nasal NHL.
Yao
Bo
B
Department of Radiation Oncology, Cancer Hospital/Cancer Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, P. R. China.
Li
Ye-Xiong
YX
Fang
Hui
H
Jin
Jing
J
Liu
Xin-Fan
XF
Yu
Zi-Hao
ZH
D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone