The median age of 45 patients was 51 years old. There were 39 cases (86.7%) of stage Ⅰ-Ⅱ, 4 cases (8.9%) of stage Ⅲ, 2 cases(4.4%) of stage Ⅳ. The median time from first onset to diagnosis was 3.0 months (1.0-36.0 months), and serumEBV-DNA positive rate was 95.6% (43/45). The complete remission (CR) rate and progression of the disease (PD) rate were statistically different of different risk groups ( χ2 = 10.952, P < 0.01; χ2 = 12.217, P = 0.002). Among 43 patients of stage Ⅰ-Ⅲ, there were 11 patients in the radiotherapy alone group, including 4 cases (36.3%) of CR, 3 cases (27.3%) of partial remission (PR), 4 cases (36.4%) of PD; and 32 patients in the chemotherapy combined with radiotherapy group, including 23 cases (71.9%) of CR, 4 cases (12.5%) of PR, 5 cases (15.6%) of PD. The difference in CR rate of both groups was statistically significant ( χ2 = 4.418, P = 0.036). Univariate analysis suggested that PINK score and B symptom were related to OS ( χ2 = 8.140, P = 0.017; χ2 = 5.545, P = 0.019). PINK score and clinical staging were associated with PFS ( χ2 = 12.517, P = 0.002; χ2 = 10.016, P = 0.002); Cox multivariate analysis indicated that clinical staging was an independent influencing factor of PFS ( HR = 4.104, 95% CI 1.571-10.725, P = 0.004).
Conclusions:
ENKTL with specific location has longer clinical diagnosistime, and the positive rate of EBV-DNA is high. The patients with B symptom and high PINK score have poor OS, and patients with late clinical staging and high PINK score have short PFS. Clinical staging is considered as an independent factor affecting PFS. The PINK score risk stratification has a guiding significance in the short-term efficacy evaluation, and the chemotherapy combined with radiotherapy can increase CR rate for patients less than stage Ⅳ.