title: Phase 2 trial of "sandwich" L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma.
abstract: BACKGROUND
  Extranodal natural killer/T-cell lymphoma (ENKTL), nasal-type, is a distinct entity of lymphoid tissue. ENKTL is sensitive to radiotherapy (RT), but the prognosis is poorer than for other types of early lymphoma. The treatment schedule is controversial.
  
  
  METHODS
  A phase 2 study was conducted of "sandwich" protocols, with earlier RT after an initial 2 to 3 cycles of LVP (L-asparaginase, vincristine, and prednisone), followed by further "consolidation" cycles. Patients aged 18 years and older who had previously untreated ENKTL and localized lesions in the upper aerodigestive tract were enrolled. The primary endpoints were objective response rate and complete remission rate. The secondary endpoints were 2-year overall survival, 2-year progression-free survival, and toxicity. This study is registered with www.Chictr.org, number ChicTR-TNC-00000394, and is ongoing for long-term follow-up.
  
  
  RESULTS
  Twenty-six patients completed total therapy, which resulted in 88.5% response that included 21 patients (80.8%) with complete response (CR) and 2 patients (7.7%) with partial response. Three (11.5%) of 26 patients progressed during therapy. With a median follow-up of 27 months (range, 4-35 months), the 2-year overall survival was 88.5%, and the 2-year progression-free survival was 80.6%. Patients with CR had better prognosis than patients without CR. Only 2 patients (7.7%) experienced grade 3 leukocytopenia. No grade 4 toxicity or treatment-related deaths were observed.
  
  
  CONCLUSIONS
  The research showed that the "sandwich" protocol of LVP combined with RT was a safe and effective treatment for localized nasal natural killer/T-cell lymphoma, and the results warrant further investigation into this protocol.
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Jiang
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.forename: Yu
authors.initials: Y
authors.lastname: Jiang
authors.forename: Qunpei
authors.initials: Q
authors.lastname: Yang
authors.forename: Li
authors.initials: L
authors.lastname: Xie
authors.forename: Weiping
authors.initials: W
authors.lastname: Liu
authors.forename: Wenyan
authors.initials: W
authors.lastname: Zhang
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Ji
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Nianyong
authors.initials: N
authors.lastname: Chen
authors.forename: Sha
authors.initials: S
authors.lastname: Zhao
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.forename: Liqun
authors.initials: L
authors.lastname: Zou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D012008:Recurrence; D014750:Vincristine / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014750:Vincristine; D001215:Asparaginase; D011241:Prednisone