曾洪福 杨瑜 吴晖 陈英 陈宁斌 邹思平 郑艳彬 王杰松 陈秀容 王畅

[摘要] 目的 观察以培门冬酶为基础的化疗方案一线治疗结外鼻型NK/T细胞淋巴瘤临床疗效及安全性。 方法 选取2012年11月～2017年11月我院收治的结外鼻型NK/T细胞淋巴瘤患者25例，分别接受GELOX方案、AspaMetDex方案化疗，评价疗效、不良反应的发生率。 结果 GELOX方案、AspaMetDex方案化疗后CR率分别为64.3%、45.5%，3年PFS分别为85.7%、72.7%，3年OS分别为85.7%、81.8%。两组的CR、PFS及OS率差异均无统计学意义（P>0.05）。主要不良反应为白细胞减少、贫血、肝转氨酶升高、胆红素升高、白蛋白下降。常见Ⅲ～Ⅳ级为白细胞减少及贫血。无过敏反应及治疗相关性死亡。 结论 以培门冬酶为基础化疗方案一线治疗结外鼻型NK/T细胞淋巴瘤疗效良好，不良反应可耐受，可考虑作为ENKTL的一线化疗方案。

[关键词] NK/T细胞淋巴瘤；化疗方案；培门冬酶；疗效；安全性

[中图分类号] R733.1 [文献标识码] B [文章编号] 1673-9701（2018）30-0071-04

[Abstract] Objective To observe the clinical efficacy and safety of pegaspargase-based chemotherapy in the first-line treatment of extranodal nasal type NK/T-cell lymphoma. Methods 25 patients with extranodal nasal type NK/T-cell lymphoma who were admitted to our hospital from November 2012 to November 2017 were selected. They were given GELOX protocol， AspaMetDex protocol， respectively. The efficacy and incidence rate of adverse reactions were evaluated. Results The CR rates of GELOX， AspaMetDex protocols were 64.3% and 45.5%， respectively. The 3-year PFS was 85.7% and 72.7%， respectively， and the 3-year OS was 85.7% and 81.8%， respectively. There were no statistically significant differences in CR， PFS and OS rates between the two groups（P>0.05）. The main adverse reactions were leukopenia， anemia， elevated liver transaminases， elevated bilirubin， and decreased albumin. Common adverse reactions with grades Ⅲ-Ⅳ were leukopenia and anemia. No allergic reactions and treatment-related deaths were observed. Conclusion Pegaspargase-based chemotherapy in the first-line treatment of extranodal nasal type NK/T-cell lymphoma has a favorable efficacy and the adverse reactions can be tolerated， which can be considered as a first-line chemotherapy protocol for ENKTL.

[Key words] NK/T-cell lymphoma； Chemotherapy protocol； Pegaspargase； Efficacy； Safety

結外鼻型NK/T细胞淋巴瘤（ENKTL）常侵及鼻及面中线部器官[1]，临床呈高度侵袭性，预后欠佳。在我国约占非霍奇金淋巴瘤的5%～10%，高于欧美[2]。早期患者常接受放化疗联合治疗方案，晚期患者治疗以化疗为主，但目前无标准化疗方案。治疗非霍奇金淋巴瘤的经典方案如CHOP、EPOCH方案，因疗效欠佳，目前已较少应用于治疗ENKTL，近几年，以培门冬酶为基础的化疗方案因疗效较佳而在临床推广应用，现将我院相关资料总结如下。

1 资料与方法

1.1一般资料

本研究回顾性分析2012年11月～2017年11月我院收治的25例接受含培门冬酶方案一线化疗的结外鼻型NK/T细胞淋巴瘤患者。纳入标准：所有病例均经过组织病理及免疫组化检查确诊；E……