title: Efficacy and tolerance of pegaspargase, gemcitabine and oxaliplatin with sandwiched radiotherapy in the treatment of newly-diagnosed extranodal nature killer (NK)/T cell lymphoma.
abstract: Extranodal nature killer (NK)/T cell lymphoma (ENKL), nasal type, is a highly aggressive and heterogeneous disease. Here we report a retrospective study of 38 newly-diagnosed ENKL patients treated with pegaspargase, gemcitabine, oxaliplatin (P-Gemox) and sandwiched radiotherapy in our department during 2012-2016. A median of 4 (range, 2-6) (total=141) cycles of P-Gemox were administered. Interim restaging after at least 2 cycles showed complete remission (CR) rate of 23.68%, partial remission (PR) rate of 63.16%, giving an overall response rate (ORR) of 86.84%. On treatment completion, the ORR became 92.1% (CR=86.84%, PR=5.26%). Only one patient experienced disease progression during therapy. Multivariate analysis showed gender was a significant independent factor impacting on CR. Hematologic toxicity was common yet nonhematologic toxicity was mild, both of them can be well controlled by supportive treatments and only one treatment-related death was observed. At a median follow-up of 15.5 months, 4 patients (10.53%) experienced disease progression and died of disease. 1-year progression-free survival (PFS) rate and 1-year overall survival (OS) rate for the whole cohort were 86.7% and 86.6%. The P-Gemox regimen with sandwiched radiotherapy may be a promising option in the treatment of newly-diagnosed ENKL due to its high efficacy yet low toxicity.
authors.affiliation: Department of Lymphoma, Sichuan Cancer Hospital, Chengdu, People's Republic of China.
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Jing
authors.affiliation: Department of Lymphoma, Sichuan Cancer Hospital, Chengdu, People's Republic of China.
authors.forename: Zhi-Hui
authors.initials: ZH
authors.lastname: Zhang
authors.affiliation: Department of Lymphoma, Sichuan Cancer Hospital, Chengdu, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wu
authors.affiliation: Department of Radiotherapy, Sichuan Cancer Hospital, Chengdu, People's Republic of China.
authors.forename: Shi-Chuan
authors.initials: SC
authors.lastname: Zhang
authors.affiliation: Department of Lymphoma, Sichuan Cancer Hospital, Chengdu, People's Republic of China.
authors.forename: Yuan-Rong
authors.initials: YR
authors.lastname: Ren
authors.affiliation: Department of Lymphoma, Sichuan Cancer Hospital, Chengdu, People's Republic of China.
authors.forename: Zhu-Juan
authors.initials: ZJ
authors.lastname: Xiong
authors.affiliation: Department of Lymphoma, Sichuan Cancer Hospital, Chengdu, People's Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Wei
authors.affiliation: Department of Lymphoma, Sichuan Cancer Hospital, Chengdu, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Luo
authors.affiliation: Department of Lymphoma, Sichuan Cancer Hospital, Chengdu, People's Republic of China. Electronic address: 490608418@qq.com.
authors.forename: Li
authors.initials: L
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D001215:Asparaginase / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D011092:Polyethylene Glycols; C042705:pegaspargase; D001215:Asparaginase; D000093542:Gemcitabine
keywords: Extranodal nature killer (NK)/T cell lymphoma; Gemcitabine; Oxaliplatin; Pegaspargase; Radiotherapy