Comparison of clinical characteristics and prognoses between primary Waldeyer's ring diffuse large B-cell lymphoma and extranodal nasal-type NK/T-cell lymphoma
WU Run-ye, LI Ye-xiong, WANG Wei-Hu, JIN Jing, WANG Shu-lian, LIU Yue-ping, SONG Yong-wen, REN Hun, FANG Hui, LIU Qing-feng, WANG Zhao-yang, QI Shu-nan, LU Ning-ning, CHEN Bo, ZHANG Xi-mei, LIU Xin-fan, YU Zi-hao
Abstract
Objective This study aimed to compare the clinical characteristics and prognoses of primary Waldeyer's ring diffuse large B-cell lymphoma (DLBCL) and extranodal nasal-type NK/T-cell lymphoma ( ENKTCL).Methods From 2000 to 2008,122 patients with primary Waldeyer's ring DLBCL and 44 patients with primary Waldeyer' s ring ENKTCL consecutively diagnosed were retrospectively compared.Patients with DLBCL usually received 4-6 cycles of CHOP-based chemotherapy followed by involved-field radiotherapy.Patients with early stage ENKTCL usually received extended-field radiotherapy with or without subsequent chemotherapy,or short courses ( 1 - 3 cycles ) of chemotherapy followed by radiotherapy.Kaplan-Meier method was used for survival analysis.Logrank method was used for univariate analysis.Results The follow-up rate was 82%.The number of patients followed 5 years were 32 and 15 in DLBCL and ENKTCL.DLBCL mainly presented with stage Ⅱ tonsillar disease with regional lymph node involvement.ENKTCL occurred predominately in young males,as nasopharyngeal stage I disease with B symptoms and involving adjacent structures.The 5-year overall survival (OS) and progression-free survival (PFS) rates were 74% and 67% in DLBCL,and 68% and 59% in ENKTCL (x2=0.53,1.06,P=0.468,0.303),respectively.In stage Ⅰ and Ⅱ diseases,the 5-year OS and PFS rates were 79% and 76% for DLBCL compared to 72% and 62% for ENKTCL (x2 =1.20,2.46,P=0.273,0.117).On univariate analysis,age > 60 years,elevated lactate dehydrogenase,eastern cooperative oncology group performance status > 1,international prognosis index ( IPI ) score ≥ 1,stage Ⅲ/Ⅳ diseases and bulky disease were associated with unfavorable survival for DLBCL (x2=9.40,12.72,6.15,10.36,12.48,5.53,P=0.002,0.000,0.013,0.001,0.000,0.019),and only age>60 years and IPI score ≥ 1 were associated with poor survival for ENKTCL (x2 =3.98,8.41,P =0.046,0.004).Conclusions These results indicate that remarkable clinical disparities exist between DLBCL and ENKTCL in Waldeyer's ring. Different treatment strategies for each can result in similarly favorable prognoses.
Key words:
Lymphoma,diffuse large B-cell,Waldeyer's ring/radiotherapy; Lymphoma,diffuselarge B-cell,Waldeyer's nng/chemotherapy; Lymphoma,extranodal nasal-type NK/T-cell,Waldeyer's ring/radiotherapy; Lymphoma,extranodal nasal-type NK/T-cell,Waldeyer's ring/cheomotherapy; Prognosis
Contributor Information
WU Run-ye
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
LI Ye-xiong
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
WANG Wei-Hu
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
JIN Jing
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
WANG Shu-lian
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
LIU Yue-ping
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
SONG Yong-wen
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
REN Hun
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
FANG Hui
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
LIU Qing-feng
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
WANG Zhao-yang
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
QI Shu-nan
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
LU Ning-ning
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
CHEN Bo
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
ZHANG Xi-mei
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
LIU Xin-fan
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China
YU Zi-hao
Departments of Radiation Oncology , Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021 ,China