Primary non-Hodgkin's lymphoma of the nasopharynx: prognostic factors and outcome of 113 Indian patients.
This single institutional study evaluated the prognostic factors and treatment outcome of 113 Indian patients with primary nasopharyngeal non-Hodgkin's lymphoma. At presentation, 28% had stage I and 62% had stage II disease. Treatment comprised of a combination of chemotherapy (CTh) and radiotherapy (RT) in the majority of the patients (76%). After a median follow-up of 56 months, the 5-year disease-free survival (DFS) and overall survival (OS) for the whole group were 55.8% and 57.9%, respectively. Multivariate analysis showed that; age > 30 years [hazard ratio (HR) = 6.59, 95% confidence interval (CI) = 2.59 - 16.7, P < 0.0001], WHO performance score > or = 2 (HR = 2.34, 95% CI = 1.01 - 5.46, P = 0.050), T-cell lymphomas (HR = 2.81, 95% CI = 1.14 - 6.96, P < 0.001) and the presence of B symptoms (HR = 3.65, 95% CI = 1.77 - 7.53, P = 0.025), had a negative influence on survival. Patients treated with a combination of CTh and RT had a significantly better outcome than those treated with CTh alone (OS: 69%vs. 31%, P < 0.00001). HR for death in the CTh alone group was 3.73 (95% CI = 1.95 - 7.13). The CR (P = 0.01), DFS (P = 0.01) and OS (P = 0.03) rates were significantly better for patients receiving a RT dose of > or =4500 cGy. HR in the subgroup that received a RT dose of <4500 cGy was 2.51 (95% CI = 1.04 - 6.06). These results suggest that combined modality treatment, comprising of CTh and RT (with an RT dose of > or =4500 cGy), results in satisfactory outcome in patients with this rare neoplasm.
Laskar
Siddhartha
S
Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. laskars2000@yahoo.com
Muckaden
Mary Ann
MA
Bahl
Gaurav
G
de
Sandeep
S
Nair
Reena
R
Gupta
Sudeep
S
Bakshi
Ashish
A
Prabhash
Kumar
K
Maru
Dipen
D
Gujral
Sumeet
S
Parikh
Purvish
P
Shrivastava
Shyam Kishore
SK
Dinshaw
Ketayun Ardeshir
KA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007194:India; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome