title: Concurrent chemoradiotherapy followed by L-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma: CISL08-01 phase II study.
abstract: We conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by 2 cycles of L-asparaginase-containing chemotherapy for patients who were newly diagnosed with stages IE and IIE nasal extranodal NK/T cell lymphoma (ENKTL). CCRT consisted of 40-44 Gy of radiotherapy with weekly administration of 30 mg/m(2) of cisplatin for 4 weeks. Two cycles of VIDL (etoposide (100 mg/m(2)), ifosfamide (1,200 mg/m(2)), and dexamethasone (40 mg) from days 1 to 3, and L-asparaginase (4,000 IU/m(2)) every other day from days 8 to 20) were administered sequentially. CCRT yielded a 90 % overall response rate without significant side effects in 30 patients, including 20 patients with complete response (CR); however, two patients showed distant disease progression. After CCRT, VIDL chemotherapy showed an 87 % final CR rate (26/30). Although grade III or IV hematologic toxicity was frequent during VIDL chemotherapy, no treatment-related mortality was observed, and L-asparaginase-associated toxicity was manageable. With a median follow-up of 44 months, 11 patients showed local (n = 4) and distant (n = 7) relapse or progression. The estimated 5-year progression-free and overall survival rates were 73 and 60 %, respectively. In conclusion, CCRT followed by L-asparaginase-containing chemotherapy is a feasible treatment for newly diagnosed stages IE/IIE nasal ENKTL.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Deok-Hwan
authors.initials: DH
authors.lastname: Yang
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Jae-Yong
authors.initials: JY
authors.lastname: Kwak
authors.forename: Hyeon-Seok
authors.initials: HS
authors.lastname: Eom
authors.forename: Dae Sik
authors.initials: DS
authors.lastname: Hong
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Won
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Dok Hyun
authors.initials: DH
authors.lastname: Yoon
authors.forename: Jaeho
authors.initials: J
authors.lastname: Cho
authors.forename: Taek-Keun
authors.initials: TK
authors.lastname: Nam
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Ahn
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001215:Asparaginase / Q000008:administration & dosage*; D059248:Chemoradiotherapy / Q000379:methods*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D001215:Asparaginase