Skip to main content

Advertisement

SpringerLink
Log in

Primary localized stages I and II non-Hodgkin’s lymphoma of the nasopharynx: a retrospective 17-year single institutional experience

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

The aim of this retrospective study was to define the natural history, clinicopathological findings, prognostic factors, and treatment outcome of 43 patients with localized stages I and II primary non-Hodgkin’s lymphoma (NHL) of the nasopharynx, followed up in a single institution over a 17-year period. Forty-three (13 women and 30 men) consecutive patients with localized stages I (N = 12) and II (N = 31) primary nasopharyngeal NHL were treated in our institution between 1990 and 2007. The pathologic reports were classified according to the International Working Formulation (N = 22) or Revised European-American Lymphoma classification (N = 21). The vast majority of patients (88%) were managed with a sequential combination of chemotherapy and radiation therapy. Chemotherapy mainly consisted of 4–8 (median 6) cycles of CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisolone). Involved-field radiation therapy with a median dose of 44 Gy was delivered to the primary site and entire cervical lymph nodes. The median age of the patients was 53 years (range, 6 to 86 years). The majority of the patients (70%) had high-grade histology. B-cell types represented 67% of the cases, among which diffuse large B cell was the most common histological subtype. After a median follow-up of 70 months, the 5-year disease-free survival and overall survival were 58.8% and 70.6%, respectively. In multivariate analysis, age less than or equal to 30 years (hazard ratio (HR) = 5.32, 95% confidence interval (CI) = 1.69–16.76), elevated serum lactate dehydrogenase level (HR = 3.69, 95% CI = 1.43–9.51), and modified International Prognostic Index with more than or equal to two risk factors (HR = 17.99, 95% CI = 2.32–139.30) retained statistical significance. Our limited data suggest that primary nasopharyngeal NHL tends to have aggressive histology and unfavorable clinical course with poor outcome, despite a considerably localized disease at the time of presentation and high frequency of complete initial response rates. Combined modality therapy should be considered for the majority of patients with primary localized nasopharyngeal NHL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Epstein JB, Epstein JD, Le ND, Gorsky M (2001) Characteristics of oral and paraoral malignant lymphoma: a population-based review of 361 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:519–525. doi:10.1067/moe.2001.116062

    Article  PubMed  CAS  Google Scholar 

  2. Vega F, Lin P, Medeiros LJ (2005) Extranodal lymphomas of the head and neck. Ann Diagn Pathol 9:340–350. doi:10.1016/j.anndiagpath.2005.09.020

    Article  PubMed  Google Scholar 

  3. Krol AD, Le Cessie S, Snijder S, Kluin-Nelemans JC, Kluin PM, Noorduk EM (2001) Waldeyer’s ring lymphomas: a clinical study from the Comprehensive Cancer Center West population based NHL registry. Leuk Lymphoma 42:1005–1013. doi:10.3109/10428190109097720

    Article  PubMed  CAS  Google Scholar 

  4. Lopez-Guillermo A, Colomo L, Jimenez M et al (2005) Diffuse large B-cell lymphoma: clinical and biological characterization and outcome according to the nodal or extranodal primary origin. J Clin Oncol 23:2797–2804. doi:10.1200/JCO.2005.07.155

    Article  PubMed  Google Scholar 

  5. Epstein JB, Epstein JD, Le ND, Gorsky M (2001) Characteristics of oral and paraoral malignant lymphoma: a population-based review of 361 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:519–525. doi:10.1067/moe.2001.116062

    Article  PubMed  CAS  Google Scholar 

  6. Laskar S, Muckaden MA, Bahl G et al (2006) Primary non-Hodgkin’s lymphoma of the nasopharynx: prognostic factors and outcome of 113 Indian patients. Leuk Lymphoma 47:2132–2139. doi:10.1080/10428190600733531

    Article  PubMed  Google Scholar 

  7. Ezzat AA, Ibrahim EM, El Weshi AN et al (2001) Localized non-Hodgkin’s lymphoma of Waldeyer’s ring: clinical features, management, and prognosis of 130 adult patients. Head Neck 23:547–558. doi:10.1002/hed.1077

    Article  PubMed  CAS  Google Scholar 

  8. Yuan ZY, Li YX, Zhao LJ et al (2004) Clinical features, treatment and prognosis of 136 patients with primary non-Hodgkin’s lymphoma of the nasopharynx. Zhonghua Zhongliu Zazhi 26:425–429 x

    PubMed  Google Scholar 

  9. The Non-Hodgkin’s Lymphoma Pathologic Classification Project (1982) National Cancer Institute sponsored study of classifications of non-Hodgkin’s lymphomas: summary and description of a working formulation for clinical usage. Cancer 49:2112–2135. doi:10.1002/1097-0142(19820515)49:10<2112::AID-CNCR2820491024>3.0.CO;2-2

    Article  Google Scholar 

  10. Harris NL, Jaffe ES, Stein H et al (1994) A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 84:1361–1392

    PubMed  CAS  Google Scholar 

  11. Menárguez J, Mollejo M, Carrión R et al (1994) Waldeyer ring lymphomas. A clinicopathological study of 79 cases. Histopathology 24:13–22. doi:10.1111/j.1365-2559.1994.tb01266.x

    Article  PubMed  Google Scholar 

  12. Harabuchi Y, Tsubota H, Ohguro S et al (1997) Prognostic factors and treatment outcome in non-Hodgkin’s lymphoma of Waldeyer’s ring. Acta Oncol 36:413–420. doi:10.3109/02841869709001289

    Article  PubMed  CAS  Google Scholar 

  13. Saul SH, Kapadia SB (1985) Primary lymphoma of Waldeyer’s ring. Clinicopathologic study of 68 cases. Cancer 56:157–166. doi:10.1002/1097-0142(19850701)56:1<157::AID-CNCR2820560125>3.0.CO;2-X

    Article  PubMed  CAS  Google Scholar 

  14. Ye YL, Zhou MH, Lu XY, Dai YR, Wu WX (1992) Nasopharyngeal and nasal malignant lymphoma: a clinicopathological study of 54 cases. Histopathology 20:511–516

    PubMed  CAS  Google Scholar 

  15. Cheung MM, Chan JK, Lau WH, Foo W, Chan PT, Ng CS (1998) Primary non-Hodgkin’s lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients. J Clin Oncol 16:70–77

    PubMed  CAS  Google Scholar 

  16. Gustavsson A, Osterman B, Cavallin-Ståhl E (2003) A systematic overview of radiation therapy effects in non-Hodgkin’s lymphoma. Acta Oncol 42:605–619. doi:10.1080/02841860310014435

    Article  PubMed  Google Scholar 

  17. Gisselbrecht C, Gaulard P, Lepage E et al (1998) Prognostic significance of T-cell phenotype in aggressive non-Hodgkin’s lymphomas. Groupe d’Etudes des Lymphomes de l’Adulte (GELA). Blood 92:76–82

    PubMed  CAS  Google Scholar 

  18. Oguchi M, Ikeda H, Isobe K, Hirota S, Hasegawa M, Nakamura K (2000) Tumor bulk as a prognostic factor for the management of localized aggressive non-Hodgkin’s lymphoma: a survey of the Japan Lymphoma Radiation Therapy Group. Int J Radiat Oncol Biol Phys 48:161–168. doi:10.1016/S0360-3016(00)00480-6

    Article  PubMed  CAS  Google Scholar 

  19. Gurkaynak M, Cengiz M, Akyurek S, Ozyar E, Atahan IL, Tekuzman G (2003) Waldeyer’s ring lymphomas: treatment results and prognostic factors. Am J Clin Oncol 26:437–440. doi:10.1097/01.coc.0000027588.56104.15

    Article  PubMed  CAS  Google Scholar 

  20. Yong W, Zhang Y, Zheng W, Wei Y (2000) Prognostic factors and therapeutic efficacy of combined radio-chemotherapy in Waldeyer’s ring non-Hodgkin lymphoma. Chin Med J (Engl) 113:148–150

    CAS  Google Scholar 

  21. Avilés A, Delgado S, Ruiz H, de la Torre A, Guzman R, Talavera A (1996) Treatment of non-Hodgkin’s lymphoma of Waldeyer’s ring: radiotherapy versus chemotherapy versus combined therapy. Eur J Cancer B Oral Oncol 32:19–23. doi:10.1016/0964-1955(95)00058-5

    Article  Google Scholar 

  22. Frata P, Buglione M, Grisanti S et al (2005) Localized extranodal lymphoma of the head and neck: retrospective analysis of a series of 107 patients from a single institution. Tumori 91:456–462

    PubMed  Google Scholar 

  23. Hoederath A, Sack H, Stuschke M, Lampka E (1996) Radiotherapy of primary extranodal non-Hodgkin’s lymphoma of the head and neck region. Results of a prospective multicenter study. Study Group NHL: early studies. Strahlenther Onkol 172:356–366

    PubMed  CAS  Google Scholar 

  24. Zucca E, Conconi A, Cavalli F (2002) Treatment of extranodal lymphomas. Best Pract Res Clin Haematol 15:533–547. doi:10.1053/beha.2002.0218

    Article  PubMed  Google Scholar 

  25. Zou GR, Zhang YJ, Xie FY et al (2006) Prognosis and treatment strategies of primary B-cell and NK/T-cell nasopharyngeal non-Hodgkin’s lymphoma at early stage. Ai Zheng 25:1543–1549

    PubMed  Google Scholar 

  26. Li YH, Jiang WQ, Huang HQ et al (2003) Clinical analysis of 75 patients with nasopharyngeal non-Hodgkin’s lymphoma. Ai Zheng 22:401–403

    PubMed  Google Scholar 

  27. Richter E, Feyerabend T, Richter J et al (1990) The radiotherapy of primary extranodal non-Hodgkin’s lymphoma of the nasopharynx. Strahlenther Onkol 166:769–773

    PubMed  CAS  Google Scholar 

  28. Lei KI, Suen JJ, Hui P et al (1999) Primary nasal and nasopharyngeal lymphomas: a comparative study of clinical presentation and treatment outcome. Clin Oncol (R Coll Radiol) 11:379–387. doi:10.1053/clon.1999.9088

    CAS  Google Scholar 

Download references

Conflicts of interest

The authors disclose any commercial or other associations that might pose a conflict of interest in connection with submitted manuscript.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, 71936-13311, Iran

    Mohammad Mohammadianpanah, Niloofar Ahmadloo, Mohammad Amin Nazer Mozaffari, Mohammad Amin Mosleh-Shirazi, Shapour Omidvari & Ahmad Mosalaei

Authors
  1. Mohammad Mohammadianpanah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Niloofar Ahmadloo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohammad Amin Nazer Mozaffari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohammad Amin Mosleh-Shirazi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shapour Omidvari
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ahmad Mosalaei
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohammad Mohammadianpanah.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mohammadianpanah, M., Ahmadloo, N., Nazer Mozaffari, M.A. et al. Primary localized stages I and II non-Hodgkin’s lymphoma of the nasopharynx: a retrospective 17-year single institutional experience. Ann Hematol 88, 441–447 (2009). https://doi.org/10.1007/s00277-008-0627-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-008-0627-0

Keywords

Search

Navigation