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目的对外周T细胞淋巴瘤非特异型的临床特征、治疗和预后进行分析,探讨其治疗策略及预后因素。方法回顾性分析1999年1月至2005年12月我院收治的58例外周T细胞淋巴瘤非特异型患者的临床特征、治疗方法和疗效与预后的关系。结果全组男性46例(79.3%);中位年龄42岁;Ⅲ/Ⅳ期27例(46.6%);IPI评分低危37例(63.8%)、低中危7例(12.1%)、高中危12例(20.7%)、高危2例(3.4%);单纯化疗15例(25.9%),化放疗联合治疗43例(74.1%)。化疗有效率76.5%,其中初始化疗CR率29.4%;加入放疗后CR率提高至47.1%。全组患者1,3,5年无病生存率和总生存率分别为41.4%、37.9%、22.4%和69.0%、46.6%、31.0%。多因素分析结果显示,近期疗效(P=0.000)和骨髓受侵(P=0.012)是本组病例的独立预后因素。结论化疗加放疗的综合治疗可提高CR率,改善远期生存。
Objective To analyze the clinical characteristics, treatment and prognosis of non-specific peripheral T-cell lymphoma (T-cell lymphoma) and discuss the therapeutic strategies and prognostic factors. Methods The clinical features, treatment, efficacy and prognosis of 58 patients with non-specific peripheral T-cell lymphoma from January 1999 to December 2005 in our hospital were retrospectively analyzed. Results There were 46 males (79.3%) with a median age of 42 years and 27 cases (46.6%) with stage Ⅲ / Ⅳ, 37 (63.8%) with low risk and 7 (12.1% There were 12 cases (20.7%) of whom were at risk and 2 cases (3.4%) at high risk; 15 cases (25.9%) were chemotherapy alone and 43 cases (74.1%) were treated by combined radiotherapy and chemotherapy. Chemotherapy efficiency was 76.5%, of which the initial chemotherapy CR rate was 29.4%; after radiotherapy, the CR rate increased to 47.1%. The 1, 3, 5 year disease-free survival rate and overall survival rate were 41.4%, 37.9%, 22.4% and 69.0%, 46.6% and 31.0% respectively in all patients. Multivariate analysis showed that the short-term efficacy (P = 0.000) and bone marrow invasion (P = 0.012) were independent prognostic factors in this group. Conclusion Combined chemotherapy and radiotherapy can improve CR rate and improve long-term survival.