title: Chemoradiotherapy for localized extranodal natural killer/T-cell lymphoma, nasal type, using a shrinking-field radiation strategy: multi-institutional experience.
abstract: OBJECTIVE
  The prognosis of localized extranodal natural killer/T-cell lymphoma, nasal type (ENKTL), has improved with the development of chemoradiotherapy. However, conventional extended-field radiotherapy may cause optic disorders. Our group has employed smaller radiation fields in an attempt to avoid toxicity. The efficacy and toxicity of treatments were evaluated.
  
  
  METHODS
  Chemoradiotherapy was delivered with a shrinking-field radiotherapy strategy. The endpoints of this study were overall survival (OS), local control (LC), progression-free survival (PFS), and toxicity.
  
  
  RESULTS
  Fifteen patients with localized ENKTL were treated. After irradiation (median, 40 Gy) to the tumor plus a prophylactic volume, a reduced treatment volume to the tumor was boosted (median, 10 Gy). Twelve patients underwent chemoradiotherapy and 3 patients received radiotherapy alone. A complete response was achieved in 12 and a partial response in 3 patients. The 5-year OS, PFS, and LC rates were 80, 67, and 93 %, respectively. Distant recurrence occurred in 4 patients and locoregional and distant recurrence in 1 patient. Cataract (grade 3) and dry eye (grade 2) were observed as late adverse events in 1 patient each.
  
  
  CONCLUSIONS
  Sufficiently high OS and LC were achieved with acceptable toxicities. Appropriate target volumes may be smaller with newer chemotherapy regimens.
authors: Nagoya Proton Therapy Center, Nagoya City West Medical Center, 1-1-1, Hirate-cho, Kita-ku, Nagoya, Aichi, 462-8508, Japan. yhattori7@yahoo.co.jp.|Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan. yhattori7@yahoo.co.jp.
authors: Yukiko
authors: Y
authors: Hattori
authors: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
authors: Taro
authors: T
authors: Murai
authors: Nagoya Proton Therapy Center, Nagoya City West Medical Center, 1-1-1, Hirate-cho, Kita-ku, Nagoya, Aichi, 462-8508, Japan.|Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
authors: Hiromitsu
authors: H
authors: Iwata
authors: Department of Radiology, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Syowa-ku, Nagoya, Aichi, 466-8650, Japan.
authors: Kaoru
authors: K
authors: Uchiyama
authors: Department of Radiology, Narita Memorial Hospital, 134, Haneihonmachi, Toyohashi, Aichi, 441-8029, Japan.
authors: Mikio
authors: M
authors: Mimura
authors: Department of Radiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan.
authors: Eriko
authors: E
authors: Kato
authors: Department of Radiation Oncology, Suzuka General Hospital, 1275-53, Yamanoue, Yasuzuka-cho, Suzuka, Mie, 513-0818, Japan.
authors: Rumi
authors: R
authors: Murata
authors: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
authors: Yuta
authors: Y
authors: Shibamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D054391:Lymphoma, Extranodal NK-T-Cell / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000628:therapy*; D009669:Nose Neoplasms / Q000628:therapy*; D011832:Radiation Injuries / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Extranodal natural killer/T-cell lymphoma, nasal type; Head and neck; Lymphoma; Radiation therapy