Complete remission after first-line radio-chemotherapy as predictor of survival in extranodal NK/T cell lymphoma.
BACKGROUND
Extranodal nasal-type NK/T-cell lymphoma is a rare and severe disease. Considering the rarity of this lymphoma in Europe, we conducted a multicentric retrospective study on nasal-type NK/T cell lymphoma to determine the optimal induction strategy and identify prognostic factors.


METHODS
Thirty-six adult patients with nasal-type NK/T-cell lymphoma were recruited and assessed. In total, 80 % of patients were classified as having upper aerodigestive tract NK/T-cell lymphoma (UNKTL) and 20 % extra-upper aerodigestive tract NK/T-cell lymphoma (EUNKTL).


RESULTS
For advanced-stage disease, chemotherapy alone (CT) was the primary treatment (84 % vs. 10 % for combined CT + radiation therapy (RT), respectively), while for early-stage disease, 50 % of patients received the combination of CT + RT and 50 % CT alone. Five-year overall survival (OS) and progression-free survival (PFS) rates were 39 % and 33 %. Complete remission (CR) rates were significantly higher when using CT + RT (90 %) versus CT alone (33 %) (p < 0.0001). For early-stage disease, CR rates were 37 % for CT alone versus 100 % for CT + RT. Quality of response was significantly associated with survival, with 5-year OS being 80 % for CR patients versus 0 % for progressive disease patients (p < 0.01).


CONCLUSIONS
Early RT concomitantly or sequentially with CT led to improved patient outcomes, with quality of initial response being the most important prognosticator for 5-year OS.
Department of Hematology, Centre Hospitalier universitaire Lyon Sud, Pierre Benite, France.
Adrien
A
Chauchet
Anne-Sophie
AS
Michallet
Françoise
F
Berger
Isabelle
I
Bedgedjian
Eric
E
Deconinck
Catherine
C
Sebban
Daciana
D
Antal
Hubert
H
Orfeuvre
Bernadette
B
Corront
Tony
T
Petrella
Maya
M
Hacini
Marie
M
Bouteloup
Gilles
G
Salles
Bertrand
B
Coiffier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult