title: Early radiotherapy has an essential role for improving survival in patients with stage I-II nasal-type of NK/T cell lymphoma treated with L-asparaginase-containing chemotherapy--a single institution experience.
abstract: The purpose of this study was to investigate the role of early radiotherapy in patients with localized-stage nasal-type natural killer (NK)/T cell lymphoma treated with L-asparaginase-containing chemotherapy. Sixty-four patients with stage I-II nasal-type NK/T cell lymphoma were enrolled in this study. All patients received an L-asparaginase-containing regimen. Thirty-four patients received late radiotherapy (RT), which was defined as receiving 6 cycles of prior chemotherapy (CT) followed by RT, and 30 patients received early RT, which was defined as receiving no more than 3 cycles of CT followed by early RT. With a median follow-up of 35 months (range, 12-49 months), 19 patients (29.7 %) died from lymphoma-related causes, and 22 patients (34.4 %) developed local and/or distant relapse. The 3-year overall survival (OS) and progression-free survival (PFS) were 84.2 and 74.3 % for early RT and 57.6 and 55.9 % for late RT, respectively, and these differences were significant (OS, p = 0.027; PFS, p = 0.034). After 2 cycles of initial CT, 58 patients achieved treatment response (complete response and partial response). For the 58 patients, there were still significant differences for 3-year OS and PFS when early RT was compared with late RT (3-year OS 94.4 vs. 58 %, P = 0.005; 3-year PFS 82.9 vs. 56.3 %, P = 0.01). Early RT has an essential role in improving survival for localized-stage nasal-type NK/T cell lymphoma (TCL) patients even when used in combination with L-asparaginase-containing CT. Prospective, randomized studies should to be performed to confirm these results.
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, No. 127, Chang Le West Road, Xi'an, 710032, Shanxi, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zang
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.forename: Shan-Quan
authors.initials: SQ
authors.lastname: Luo
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Wang
authors.forename: Man
authors.initials: M
authors.lastname: Xu
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Zhao
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Li
authors.forename: Hua
authors.initials: H
authors.lastname: Yang
authors.forename: Feng
authors.initials: F
authors.lastname: Xiao
authors.forename: Ying J
authors.initials: YJ
authors.lastname: Hitchcock
authors.forename: Mei
authors.initials: M
authors.lastname: Shi
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* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult
chemical_list: D001215:Asparaginase