Variable clinical presentations of nasal and Waldeyer ring natural killer/T-cell lymphoma.
OBJECTIVE
To determine the clinical characteristics, prognosis, and treatment outcome for patients with nasal natural killer (NK)/T-cell lymphoma (N-NKTL) and Waldeyer ring NK/T-cell lymphoma (WR-NKTL).


METHODS
A total of 145 patients with N-NKTL and 95 patients with WR-NKTL were compared.


RESULTS
Compared with N-NKTL, WR-NKTL exhibited distinct differences in clinical features with a propensity for nodal involvement, more advanced stages, low elevated lactate dehydrogenase, intermediate chemosensitivity, and a favorable prognosis. Compared with patients with WR-NKTL, patients with N-NKTL were associated with a lower overall response (54% versus 89%) and higher persistent or progressive disease after initial chemotherapy (46% versus 11%; P = 0.000). The 5-year overall survival and progression-free survival rates were 67% and 56% for N-NKTL and 65% and 47% for WR-NKTL, respectively. Patients with stage II WR-NKTL showed favorable prognosis compared with those with stage II N-NKTL. Compared with radiotherapy alone, patients with early-stage WR-NKTL that received radiotherapy and chemotherapy showed a superior progression-free survival and improved overall survival. In contrast, the addition of chemotherapy to radiotherapy did not provide any survival benefit for patients with early-stage N-NKTL.


CONCLUSIONS
N-NKTL and WR-NKTL represent heterogeneous groups with variable clinical features, responses, prognosis, and treatment options.
Li
Ye-Xiong
YX
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. yexiong@yahoo.com
Liu
Qing-Feng
QF
Fang
Hui
H
Qi
Shu-Nan
SN
Wang
Hua
H
Wang
Wei-Hu
WH
Song
Yong-Wen
YW
Lu
Jiade
J
Jin
Jing
J
Wang
Shu-Lian
SL
Liu
Yue-Ping
YP
Lu
Ning
N
Liu
Xin-Fan
XF
Yu
Zi-Hao
ZH