title: Novel treatment for early-stage nasal natural killer/T-cell lymphoma: intra-maxillary arterial infusion chemotherapy with concomitant radiotherapy.
abstract: Nasal natural killer (NK)/T-cell lymphoma (NNKTL) displays unusual clinicopathological features, and the prognosis is very poor, even in the early stages of the disease. For early stage NNKTL, we have developed a novel chemoradiotherapy regimen incorporating arterial infusion chemotherapy, administered via the superficial temporal artery, in combination with radiotherapy. The novel arterial infusion regimen consists of ifosfamide, carboplatin, methotrexate, peplomycin, and etoposide (MPVIC-P). From 2003 to 2011, 12 patients with early stage NNKTL were treated with the MPVIC-P regimen via arterial infusion with concomitant radiotherapy (54 Gy). We have previously reported on the presence of Epstein-Barr virus (EBV) genetic DNA in NNKTL. Therefore, the effect of the treatment was evaluated by using both clinical findings and serum EBV DNA copy number. The observation period ranged from 39 months to 111 months post-treatment (median: 81 months). All 12 patients achieved and maintained complete remission and, to date, show no sign of relapse. Serum EBV DNA copy numbers decreased to below detectable levels in all 12 patients tested. Manageable mucositis was the most common grade 3-4 toxicity, and it was seen in 10 (83%) patients. However, grade 3-4 hematological toxicity was only seen in 4 (33%) patients. We conclude that our regimen of intra-maxillary arterial chemotherapy with concomitant radiotherapy is an effective treatment with minimal toxicity for early stage NNKTL. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, 078-8510, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Takahara
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, 078-8510, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nagato
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, 078-8510, Japan.
authors.forename: Kan
authors.initials: K
authors.lastname: Kishibe
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, 078-8510, Japan.
authors.forename: Seigo
authors.initials: S
authors.lastname: Ueda
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, 078-8510, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Komabayashi
authors.affiliation: Department of Radiology, Asahikawa Medical University, Asahikawa, 078-8510, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yamashina
authors.affiliation: Department of Radiology, Asahikawa Medical University, Asahikawa, 078-8510, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, 078-8510, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Harabuchi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007694:Killer Cells, Natural / Q000473:pathology*; D054391:Lymphoma, Extranodal NK-T-Cell; D016399:Lymphoma, T-Cell / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000473:pathology / Q000628:therapy*
keywords: Arterial infusion chemotherapy with concomitant radiotherapy; MPVIC-P regimen; Nasal natural killer/T-cell lymphoma; Serum Epstein-Barr virus copy number