The Clinical Diagnosis And Treatment Of Extranodal NK/T Cell Lymphoma Nasal Type And Its Prognostic Analysis(41Cases Report)

Objects: To analyze the clinical characteristics of carcinomas of extranodal NK/T celllymphoma nasal type and study diagnostic strategies as well as treatmentsand prognosis.Methods: A retrospective analysis of41cases of ENKCL was taken in Fujian MedicalUniversity Union Hospital from May2007to May2012.Results: The following results came from41cases of ENKCL in which the medianage was39years old, and the proportion of male and female patients was4:1. Sites more commonly involved were nasal part. B-symptoms werepresent in63.4％of the patients.36.6％of these patients had more thanone region extranodal involved.26.8％of these patients had bone marrowinvolvement.41.5％had stage I disease,7.3％had stage II disease,17.1％had stage III disease, and34.1%had stage IV disease.53.6％of thepatients had international prognostic index (IPI) of0or1.58.5％of thepatients had Personal Status score of0or1.41.5％of the patients hadLDH been elevated. Before treatment,43.9％complicated with anemia,and29.3％complicated with leucocytopenia. The average overall survivaltime was33.8months. The1year and2year overall survival (OS) rateswere51.2％,31.7％.The The overall remission rate (ORR)of radiotherapyalone was apparently higher than chemotherapy alone（100％vs13.4％）.The1year overall survival (OS) rates of multidisciplinary therapy washigher than radiotherapy or chemotherapy alone（P＜0.05）.13patientsreceived the chemotherapy for at least3cycles. Most of cases were givenfirst-line anthracycline based chemotherapy. According to COX regressionmultiple-factor analysis, international prognostic index(IPI), WBC beforetreatment and therapeutic effect in the first course would all influence the prognosis greatly.Conclusions: ENKCL is a rare disease and with poor prognosis. internationalprognostic index(IPI), WBC before treatment and therapeutic effect inthe first course are independent prognostic factors in our study, but it needsfurther confirmation．To treat the ENKCL in the early stage, radiotherapycan achieve a better effect. Multidisciplinary therapy to the patients couldeffectively provide a better prognosis than single therapy.