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[Clinical study of extranodal NK-T cell lymphoma-nasal type].

OBJECTIVE
To discuss how the diagnosis, misdiagnosis and different treatment modalities affect the prognosis of the patients with extranodal NK-T cell lymphoma-nasal type.


METHODS
A retrospective study was made on the clinical characteristics, treatment modality, short-term effect, and survival rate of 68 patients with extranodal NK-T cell lymphoma-nasal type. Among them,60 patients staged I(E) were subdivided into single therapy group of 20 cases( radiation therapy 9 cases, chemotherapy 11 cases) and combined therapy group of 40 cases (9 cases with radiation therapy + chemotherapy, 12 cases with chemotherapy + radiation therapy,19 cases with chemotherapy + radiation therapy + chemotherapy). Eight patients staged IV(E) included 3 cases with radiation therapy alone and 5 cases with chemotherapy and radiation therapy.


RESULTS
The rate of misdiagnosis of whole group is 66. 2% (45/68), and the rate of misoperated patients accounted for 52. 9% (36/68). The CR rate of radiation therapy was 94. 4% (17/18) for limited disease in I(E) group compared 61.9% (26/42) for out-cavity disease in I(E) group, of which the difference is significant (P =0. 012). The 1-years, 3-years and 5-years survival rate of the I(E) intra-cavity group were 100%, 77.8%, 59.8%, and those of ex-cavity group were 80.1%, 48.5% and 14.6%, respectively. The 1, 3 and 5-years survival rate of IV(E) group were 17.5%, 0.0% and 0.0%. The difference of survival was significance among the above 3 groups (P = 0. 000). The 1, 3, 5-years survival rate of 60 I(E) patients with single therapy were 68.4%, 22.8% and 7.6% respectively; and that of combined therapy group were 94.9%, 81.1% and 52.4% respectively, which was significant difference (P = 0. 000). The survival difference among the radiation therapy + chemotherapy group, chemotherapy + radiation therapy group and chemotherapy + radiation therapy + chemotherapy group were not significant (P = 0.088).


CONCLUSIONS
The early clinical manifestation of extranodal NK-T cell lymphoma-nasal type is not typical,which is easy to be misdiagnosed and mistreated. Early therapy is the key,which can achieve good location control. Diseased stage I(E) out-cavity and above should be treated with combined therapy.