| 齐菲,柴玥,韦雨策,等.早期结外NK/T细胞淋巴瘤不同治疗模式的探索:一项基于SEER数据库的回顾性对照研究[J].中华放射医学与防护杂志,2020,40(5):372-378.Qi Fei,Chai Yue,Wei Yuce,et al.Different treatment modalities for patients with early stage extranodal NK/T-cell lymphoma: A retrospective comparative study based on the SEER database[J].Chin J Radiol Med Prot,2020,40(5):372-378 |
| 早期结外NK/T细胞淋巴瘤不同治疗模式的探索:一项基于SEER数据库的回顾性对照研究 |
| Different treatment modalities for patients with early stage extranodal NK/T-cell lymphoma: A retrospective comparative study based on the SEER database |
| 投稿时间：2020-01-21 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.05.008 |
| 中文关键词: 结外NK/T细胞淋巴瘤 放化疗 综合治疗 生存获益 SEER数据库 |
| 英文关键词:Extranodal NK/T-cell lymphoma Chemoradiotherapy Combined treatment Surrival benefit Surveillance, epidemiology and end results database |
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| 中文摘要: |
| 目的 基于美国监测、流行病学及预后 （Surveillance，Epidemiology and End Results，SEER） 数据库的资料，于西方早期结外NK/T细胞淋巴瘤 （extranodal NK/T-cell lymphoma，ENKTCL） 患者人群中探讨不同治疗模式的有效性。方法 收集2000—2016年SEER数据库登记、病理确诊的448例早期ENKTCL患者的临床病理及生存资料，其中分别有108例患者接受单纯化疗，100例患者接受单纯放疗，240例患者接受放化疗联合治疗。通过单因素、多因素分析及倾向评分匹配方法比较不同治疗模式对患者生存的影响。结果 总体人群的中位总生存（OS）时间为59.0个月，5年OS率为49.0%。不同治疗模式对OS有显著影响，接受放化疗综合治疗、单纯放疗、单纯化疗患者的5年OS率分别是62.1%、41.5%和28.5% （χ2=41.727，P<0.001）。与单纯化疗相比，接受放疗±化疗患者的5年OS率显著提高 （55.9% vs. 28.5%，χ2=10.823，P<0.001）。与单纯放疗相比，化疗的加入进一步提高早期ENKTCL患者5年OS率，降低了死亡风险 （HR 0.578，95% CI：0.413~0.808，P=0.001）。通过倾向评分匹配方法，均衡单纯放疗组和放化疗综合治疗组的基线预后因素后，对比单纯放疗，放化疗综合治疗仍证实可带来生存获益 （5年OS率，61.3% vs. 40.5%，HR 0.572，95% CI：0.369~0.885，P=0.012）。结论 基于SEER数据库的分析结果证实，对比单纯放疗或单纯化疗，放化疗综合治疗是早期ENKTCL患者最佳的治疗模式。 |
| 英文摘要: |
| Objective To explore the effectiveness of the treatment modality among western localized extranodal NK/T-cell lymphoma (ENKTCL) patients based on the Surveillance, Epidemiology and End Result (SEER) database. Methods A total of 448 cases of early stage ENKTCL, diagnosed from 2000 to 2016, were identified from the SEER database:108 received chemotherapy alone, 100 received radiation alone, and 240 had combined chemoradiotherapy. Overall survival (OS) were compared between different modalities using univariate, multivariate and propensity-score matched (PSM) method. Results The median overall survival (OS) and 5-year OS rate were 59.0 months and 49.0% for the whole cohort, respectively. Different treatment modalities were significantly associated with OS of patients with localized ENKTCL. Patients who received chemoradiotherapy had the highest 5-year OS rate followed by those who received radiation alone and chemotherapy alone (62.1% vs. 41.5% vs. 28.5%, χ2=41.727,P<0.001). Patients who received radiation with/without chemotherapy had significant superior survival outcome compared with those who received chemotherapy alone (5-year OS rate, 55.9% vs. 28.5%, χ2=10.823,P<0.001). Furthermore, compared with radiation alone, additional chemother-apy to radiation provided survival benefit and reduced death hazard for localized ENKTCL (HR 0.578, 95% CI:0.413~0.808, P=0.001). After baseline prognostic factors adjustment using PSM method, similar survival benefit was still observed among patients treated with chemoradiotherapy over those treated with radiation alone (5-year OS, 61.3% vs. 40.5%, HR 0.592, 95% CI:0.369~0.885, P=0.012). Conclusions These results based on SEER database indicate that compared with radiation or chemotherapy alone, chemoradiotherapy is more preferable treatment option for patients with early stage ENKTCL. |
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