Clinical analysis of 36 patients with nasal extranodal natural killer/T cell lymphoma treated by P-Gemox regimen combined with radiotherapy

Abstract

Objective To explore the clinical therapeutic effects, prognosis and influencing factors of patients with nasal extranodal natural killer/T cell lymphoma (ENKL) who accepted treatment of P-Gemox regimen combined with radiotherapy. Methods From March 2003 to March 2019, a total of 36 patients ENKL with Ann Arbor ⅠE/ⅡE stage who were admitted to the Lymphoma Center of Tangdu Hospital Affiliated to Air Force Military Medical University were included in this study. They were treated with with P-Gemox regimen and radiotherapy. The retrospective method was used to analyze the patients′ efficacy and prognosis. The follow-up period was up to May 31, 2019. Survival curves of 36 patients with ENKL were drawn by Kaplan-Meier method. Univariate analysis of different influencing factors, such as gender, age, primary nasal lesions, lactate dehydrogenase (LDH), Epstein-Barr virus were performed by Log-rank test. The procedures of this study were accordance with the requirements of the revised World Medical Association Declaration of Helsinki in 2013. Informed consent was obtained from all participants before treatment. Results ① Among the 36 ENKL patients, 26 cases (72.2%) achieved complete remission (CR), 8 cases (22.2%) achieved partial remission (PR), 1 case (2.8%) achieved stable disease (SD), and 1 case (2.8%) had progressive disease (PD). ② The 5-year progression-free survival (PFS) rate was 62.9%, 5-year overall survival (OS) rate was 83.1% in the study. ③ Results of univariate analysis showed that the 5-year OS rates of patients with primary and non-nasal primary lesions were 71.8% and 100.0%, respectively, and the 5-year PFS rates were 50.0% and 95.2%, respectively. There were significant differences between them (χ2=8.253, P=0.004; χ2=14.330, P=0.001). The 5-year OS rates of patients with age ≥60 years and age <60 years were 72.7% and 96.0%, respectively, and 5-year PFS rates were 71.4% and 86.4%, respectively. The differences were also statistically significant (χ2=8.904, P=0.003; χ2=5.197, P=0.023). Conclusions Patients with ⅠE/ⅡE stage ENKL who received P-Gemox regimen combined with radiotherapy were effective and reliable. Primary nasal lesions and age ≥60 years are the influencing factors of prognosis in ENKL patients. For such patients, they should participate in relevant clinical trials and try new targeted drugs. Key words: Lymphoma, extranodal NK-T-Cell; Drug therapy, combination; Radiotherapy; Nasal cavity