Early or up-front radiotherapy improved survival of localized extranodal NK/T-cell lymphoma, nasal-type in the upper aerodigestive tract.
OBJECTIVE
To investigate the role of early or up-front radiotherapy (RT), the optimal RT dose required to achieve appropriate treatment outcome and prognostic factors for patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract.


METHODS
Eighty-two patients were reviewed. Eight patients were treated with chemotherapy (CT) alone, 9 patients received RT alone, and 65 patients were given combined modality treatment of CT and RT (CMT). Of those 74 patients receiving RT, 31 patients were given up-front RT, whereas CT was the initial therapy for 43 patients and 41 of those 43 patients received early RT.


RESULTS
Five-year overall survival (OS) and disease-free survival (DFS) were 52.3% and 39.2%, respectively. RT was the only independent prognostic factor for both OS and DFS at both the univariate and multivariate level. The 5-year OS and DFS were better in patients receiving >or=54 Gy of RT as compared with that of <54 Gy (5-year OS 75.5% vs. 46.1%, p = 0.019; 5-year DFS 60.3% vs. 33.4%, p = 0.004). Up-front RT presented better survival in Stage I patients when compared with that of initial CT followed by early RT (5-year OS 90.0% vs. 48.9%, p = 0.012; 5-year DFS 78.7% vs. 39.9%, p = 0.021).


CONCLUSIONS
Early or up-front RT had an essential role in improved OS and DFS in patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. The recommended tumor dose was at least 54 Gy. Up-front RT may yield more benefits on survival in patients with Stage I disease.
Huang
Mei-Juan
MJ
Department of Biotherapy for Cancer, West China Hospital, Medical School, Sichuan University, Chengdu, People's Republic of China.
Jiang
Yu
Y
Liu
Wei-Ping
WP
Li
Zhi-Ping
ZP
Li
Mei
M
Zhou
Lin
L
Xu
Yong
Y
Yu
Chun-Hua
CH
Li
Qiu
Q
Peng
Feng
F
Liu
Ji-Yan
JY
Luo
Feng
F
Lu
You
Y
D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D013899:Thoracic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D016896:Treatment Outcome