Extranodal NK/T-cell lymphoma, nasal type: a clinical analysis

Abstract

Objective:To explore the clinical diagnosis and treatment characteristics and clinical factors of extranodal NK/T-cell lymphoma, nasal type and provide the basis for clinical individual therapy and experience.Method:The 25 cases personal data of ENKTL received from December in 2009 to July in 2016 by our department including clinical manifestation, the serum EBV-DNA detection, imaging examination, Ann-Arbor staging, histological grade, treatment, and prognosis, etc. were retrospectively analyzed. All of the patients were pathological diagnosis and received standard, specification and system treatment. Single factor survival analysis was performed by Kaplan-Meier method and Log-rank test, and multivariate analysis was carried out using Coxproportional hazard model in the risk assessment about the factors affecting the prognosis of clinical.Result:Of the 25 patients, 15 cases(60%) were in stage ⅠE-ⅡE, which 1 year and 3 years (overall survival) OS were 100%, 100% respectively and 10 cases(40%) were in stage ⅢE-ⅣE, which 1 year and 3 years OS were respectively 40.0%, 26.7%. It had significant statistical difference (P= 0.000). Radiotherapy alone in 3 cases which 1 year and 3 years OS were respectively 100%, 100%;Chemotherapy alone in 6 cases, which 1 year and 3 years OS were 53.6% and 53.6%, respectively; 16 cases of comprehensive treatment combined radiation and chemotherapy which 1 year and 3 years OS are 84.6% and 84.6% respectively. There were significant difference between three kinds of treatment model (P= 0.027), and chemotherapy alone had the worst prognosis. Further multivariate analysis using Coxproportional hazard model showed that the course of the disease, B symptoms, EBV-DNA copy number positive, treatment mode closely associated with the prognosis (P were 0.006, 0.003, 0.010, 0.040 respectively).Conclusion:Extranodal NK/T-cell lymphoma, nasal type invasive is strong, the overall prognosis is poor. For early Ann Arbor staging, low risk and limited to the nasal cavity cases, radiotherapy alone curative effect is better. While for strong attack range or terminal patients, chemotherapy combined with radiotherapy is the first selection. In addition, this result shows that Ann Arbor staging, treatment pattern, the course of the disease, B symptoms, EBV-DNA copy number positive are independent prognostic factors.