Statistical analysis of localized non-Hodgkin's lymphomas of the head and neck - Multivariate analysis of prognostic factors and evaluation of therapeutic modalities -

Prognostic factors and treatment outcome of 48 patients with Stage I (29) or II (19) non-Hodgkin's lymphoma of the head and neck were analyzed retrospectively. There were 26 males and 22 females, aged from 15 to 89 years old, with an average age of 57. The primary lesion was located in Waldeyer's ring in 25 patients, the nasal cavity and paranasal sinuses in 13, cervical lymph nodes in 8, and others in 2. Histologically, 2 had low grade lymphoma, 42 had intermediate grade disease, and 1 had high grade disease. The patients were treated with radiation alone (5 patients), chemotherapy according to a cyclophosphamide, doxorubicin, vincristine, predonisone-(CHOP) regimen (8 patients), or a combination of both treatments (35 patients). In univariate analyses, an unfavorable prognosis was associated with age≥60, Stage I disease, and extralymphatic lesion. Multivariate analysis showed that an extralymphatic lesion was a significant independent risk factor for death (p=0.0093). The overall five-year survival rate was 73.5%. Differences in the treatment was not reflected in the outcome. Our results suggest that a combination of chemotherapy (CHOP) and radiation is an appropriate treatment for lymphatic stage I and II non-Hodgkin's lymphoma of the head and neck. However, more intensive therapy is necessary for patients with extralymphatic head and neck NHL.