title: Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study.
abstract: OBJECTIVE
  On the basis of the benefits of frontline radiation in early-stage, extranodal, natural killer (NK)/T-cell lymphoma (ENKTL), we conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by three cycles of etoposide, ifosfamide, cisplatin, and dexamethasone (VIPD).
  
  
  METHODS
  Thirty patients with newly diagnosed, stages IE to IIE, nasal ENKTL received CCRT (ie radiation 40 to 52.8 Gy and cisplatin 30 mg/m(2) weekly). Three cycles of VIPD (etoposide 100 mg/m(2) days 1 through 3, ifosfamide 1,200 mg/m(2) days 1 through 3, cisplatin 33 mg/m(2) days 1 through 3, and dexamethasone 40 mg days 1 through 4) were scheduled after CCRT.
  
  
  RESULTS
  All patients completed CCRT, which resulted in 100% response that included 22 complete responses (CRs) and eight partial responses (PRs). The CR rate after CCRT was 73.3% (ie, 22 of 30 responses; 95% CI, 57.46 to 89.13). Twenty-six of 30 patients completed the planned three cycles of VIPD, whereas four patients did not because they withdrew (n = 2) or because they had an infection (n = 2). The overall response rate and the CR rate were 83.3% (ie; 25 of 30 responses; 95% CI, 65.28 to 94.36) and 80.0% (ie, 24 of 30 responses; 95% CI, 65.69 to 94.31), respectively. Only one patient experienced grade 3 toxicity during CCRT (nausea), whereas 12 of 29 patients experienced grade 4 neutropenia. The estimated 3-year, progression-free and overall survival rates were 85.19% (95% CI, 72.48 to 97.90) and 86.28% (95% CI, 73.97 to 98.59), respectively.
  
  
  CONCLUSIONS
  Patients with newly diagnosed, stages IE to IIE, nasal ENKTL are best treated with frontline CCRT.
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.forename: Byung Soo
authors.initials: BS
authors.lastname: Kim
authors.forename: Chul Yong
authors.initials: CY
authors.lastname: Kim
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.forename: Jooryung
authors.initials: J
authors.lastname: Huh
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Jaeho
authors.initials: J
authors.lastname: Cho
authors.forename: Gyeong-Won
authors.initials: GW
authors.lastname: Lee
authors.forename: Ki Mun
authors.initials: KM
authors.lastname: Kang
authors.forename: Hyeon Seok
authors.initials: HS
authors.lastname: Eom
authors.forename: Hong Ryull
authors.initials: HR
authors.lastname: Pyo
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Ahn
authors.forename: Young Hyeh
authors.initials: YH
authors.lastname: Ko
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D056910:Republic of Korea; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005047:Etoposide; D003907:Dexamethasone; D002945:Cisplatin; D007069:Ifosfamide