论文：鼻腔非霍奇金淋巴瘤的化学治疗及放射治疗,论文

【关键词】,鼻肿瘤/药物疗法；鼻肿瘤/放射疗法；淋巴瘤,非霍奇金/药物疗法；淋巴瘤,非霍奇金/放射疗法；综合疗法；预后

【摘要】目的：探讨不同治疗方法对鼻腔非霍奇金淋巴瘤（NHL）患者的预后影响。方法：在59例原发于鼻腔NHLIE期患者中，化疗＋放疗33例，放疗＋化疗8例，单纯化疗10例，单纯放疗8例，化疗方案为CHOP。结果：全组患者的1，3，5年生存率分别为712%，420%和385%，不同治疗方法的生存率差异无显著性（P=03943），但生存曲线显示，放化组优于其他组。临床分期显示，IE局限组患者1，3，5年生存率为842%、677%和620%，IE超腔组患者为500%、143%和143%，差异有显著性（P=00012）。首程化疗≥3个周期24例，首程放疗≥40Gy16例，完全缓解率（CR率）分别为250%和750%，差异无显著性（P=0002）。首程化疗2，3～4，5～6个周期的CR率分别为105%、250%和250%，差异无显著性（P=048），并发症发生率及治疗相关死亡率均以化放组为高（394%，152%），但差异无显著性（P=0202，P=0693）。结论：I期鼻腔NHL患者首选放疗，以尽早达到局部控制，再根据临床分期及恶性程度或国际预后指数（IPI）酌情给予更有效的化疗方案。

【关键词】鼻肿瘤/药物疗法；鼻肿瘤/放射疗法；淋巴瘤，非霍奇金/药物疗法；淋巴瘤，非霍奇金/放射疗法；综合疗法；预后

【ABSTRACT】Objective：ToinvestigatetheeffectsofdifferenttreatmentsontheprognosisofpatientswithnonHodgkinslymphomasinnasalcavity.Methods:Aretrospectivestudyon59patientswhosufferedfromstageIEprimarynonHodgkinslymphomasinnasalcavitywaspresented.TheyweretreatedbyradiotherapyandchemotherapyofCHOPregimen,inwhich33patientsreceivedchemotherapyplusradiotherapy,8patientsreceivedradiotherapypluschemotherapy,10patientsreceivedchemotherapyalone,and8patientsreceivedradiotherapyalone.SurvivalanalysiswasperformedbyKaplanMeiermethod,thedifferencebetweengroupswasevaluatedbylogranktest,andthecomparisonofrateswascarriedoutbyχ2test.Results:Thetotalsurvivalratesfor1,3and5yearwere712%,420%and385%respectively.Therewasnosignificantdifferenceamongthepatientsreceiveddifferenttreatments（χ2=298,P=03943）,butthepatientsreceivedradiotherapypluschemotherapyseemedtohaveabettersurvivalratesthanthatofotherpatients.The1,3and5yearsurvivalrateswere842%,677%and620%forlesionlimitedinnasalcavitybutwere500%,143%and143%forlesionextendingintoandinvolvingintheadjacentstructures（χ2=1046,P=00012）,Astheinitialtherapy,24patientswhoreceivedchemotherapymorethan3cycles,and16patientswhoreceivedradiotherapymorethan40Gy,thecompleteresponse（CR）rateswere250%,and750%（χ2=9697,P=0002）.Among43patientsreceivingchemotherapy,the