Journal of Clinical Oncology, Vol 13, 666-670, Copyright © 1995 by American Society of Clinical Oncology
Treatment outcome and prognostic factors for primary nasal lymphoma
R Liang, D Todd, TK Chan, E Chiu, A Lie, YL Kwong, D Choy and FC Ho
Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam.
PURPOSE: To report our experience managing a large series of Chinese
patients with primary nasal lymphoma. PATIENTS AND METHODS: From January
1975 to December 1993, 100 patients (median age, 50 years) with newly
diagnosed primary nasal lymphoma were studied. There were four low-grade,
62 intermediate-grade, nine high-grade, and 25 unclassifiable lymphomas.
Immunophenotyping was performed in 45 patients: eight B cell, 35 T cell,
and two uncertain. All cases of angiocentric lymphoma that were typed were
T cell. Fifty-two patients had stage I disease, 15 had stage II, four had
stage III, and 29 had stage IV. Only 15 patients had B symptoms (weight
loss, night sweats, and/or fever), and 11 had bulky disease. Thirty-nine
patients with clinically localized stage I and II disease received local
radiotherapy alone (before 1980), and the remaining 28 stage I and II
patients received combination chemotherapy followed by local radiotherapy.
The 33 patients with advanced stage III and IV disease were given
combination chemotherapy, and additional radiotherapy was given to five of
them who had bulky local disease. RESULTS: Significantly higher complete
remission rates were observed in patients with early stages of disease and
those without B symptoms. Superior disease-free survival after complete
remission was observed in patients with stage I/II disease. Univariate
factors associated with a better overall survival included age less than 60
years, stage I disease, and absence of B symptoms. Survival was
significantly better in the subgroup of patients with stage I disease.
CONCLUSION: Patients with nasal lymphoma, especially those with advanced
disease, seemed to have a poor prognosis, and their clinical outcome was
not improved significantly by the use of chemotherapy instead of
radiotherapy or the use of doxorubicin-containing chemotherapeutic
regimens.
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