비부비동 악성 림프종에 대한 임상고찰: 치료방침 및 예후인자
Clinical Analysis of Sinonasal Malignant Lymphoma: Treatment Modalities and Prognostic Factors
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Background and Objectives Sinonasal malignant lymphoma is rare and aggressive. Itslow incidence has made detailed studies on epidemiology, survival, and consensus treatmentmodalities a challenge, and also has limited developing standardized protocols for diagnosisand management. This study analyzes the clinical factors of patients diagnosed with sinonasalmalignant lymphoma and their treatment modalities to understand therapeutic outcome andprognostic factors. Subjects and Method The medical records of patients diagnosed between 2011 and 2020 assinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse largeB cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed. Results A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL,12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of thepatients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survivalrate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and theaverage of disease-free survival period was approximately 41.1 and 22.1 months, respectively,after initiation of treatment. Conclusion We found that sinonasal malignant lymphoma is highly responsive to chemo orchemoradiotherapy. Early accurate diagnosis is important as early-stage patients receivingtherapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguoussituations, wide excision should be considered for diagnosis.
Abstract
Background and Objectives Sinonasal malignant lymphoma is rare and aggressive. Itslow incidence has made detailed studies on epidemiology, survival, and consensus treatmentmodalities a challenge, and also has limited developing standardized protocols for diagnosisand management. This study analyzes the clinical factors of patients diagnosed with sinonasalmalignant lymphoma and their treatment modalities to understand therapeutic outcome andprognostic factors. Subjects and Method The medical records of patients diagnosed between 2011 and 2020 assinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse largeB cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed. Results A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL,12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of thepatients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survivalrate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and theaverage of disease-free survival period was approximately 41.1 and 22.1 months, respectively,after initiation of treatment. Conclusion We found that sinonasal malignant lymphoma is highly responsive to chemo orchemoradiotherapy. Early accurate diagnosis is important as early-stage patients receivingtherapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguoussituations, wide excision should be considered for diagnosis.
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