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背景与目的:对于亚洲和中国较为常见的PTCL,其生物学行为与B细胞NHL不同,往往表现为化疗疗效不佳,病情迁延,容易复发,预后不良。我们回顾性分析外周T细胞淋巴瘤-非特异性(PTCL-U)患者的临床特征和预后因素。方法:收集1997年1月—2003年12月我院根据REAL分类确诊的117例初治PTCL-U患者的临床资料,回顾性分析其临床特征、治疗方法和疗效与预后的关系。结果:本组患者多为Ⅰ/Ⅱ期(69.2%);结外侵犯多见共101例(86.3%),结外侵犯部位数大于1个者41例(35.0%);IPI评分多为低危(71.8%)。117例患者中采用单纯化疗69例(59.0%),化放疗联合治疗41例(35.0%),113例(96.6%)化疗患者中采用标准CHOP方案占97例(85.8%)。化疗加局部放疗总有效率78.1%,CR率59.6%。其中单用化疗有效率74.3%,CR率为50.4%。中位有效维持时间19个月(1~89个月)。1年、3年和5年生存率分别为70.5%、43.2%和21.5%。多因素分析结果表明IPI是独立的预后危险因素(P=0.023)。结论:采用CHOP化疗方案治疗PTCL-U疗效欠佳,远期生存率低,仍需寻找更有效方案。IPI评分是PTCL-U独立的预后因素。
BACKGROUND & OBJECTIVE: The biological behavior of PTCL, which is more common in Asia and China, is different from that of B-cell NHL. Chemotherapy often shows poor curative effect, prolonged illness, recurrence and poor prognosis. We retrospectively analyzed the clinical features and prognostic factors in patients with peripheral T-cell lymphoma-nonspecific (PTCL-U). Methods: The clinical data of 117 newly diagnosed PTCL-U patients diagnosed in our hospital from January 1997 to December 2003 were retrospectively analyzed. The relationship between clinical features, treatment methods, curative effect and prognosis was retrospectively analyzed. Results: Most of the patients in this group were stage Ⅰ / Ⅱ (69.2%), 101 cases (86.3%) had common extranodal invasion, 41 cases (35.0%) had more than one extranodal site. The IPI scores were mostly low Dangerous (71.8%). Among 117 patients, 69 cases (59.0%) were treated with chemotherapy alone, 41 (35.0%) with combined radiotherapy and chemotherapy and 97 (85.8%) with standard CHOP regimen in 113 patients (96.6%). The total effective rate of chemotherapy and local radiotherapy was 78.1% and CR rate was 59.6%. Chemotherapy alone was 74.3% effective and CR was 50.4%. The median effective maintenance time of 19 months (1 to 89 months). The 1-, 3- and 5-year survival rates were 70.5%, 43.2% and 21.5% respectively. Multivariate analysis showed that IPI was an independent prognostic risk factor (P = 0.023). CONCLUSIONS: The use of CHOP chemotherapy for the treatment of PTCL-U is ineffective and the long-term survival rate is low, and more effective solutions are still needed. The IPI score is an independent prognostic factor for PTCL-U.