Clinical impact of induction treatment modalities and optimal timing of radiotherapy for the treatment of limited-stage NK/T cell lymphoma.
This study retrospectively investigated the optimal timing of radiotherapy (RT) in patients with limited-stage extranodal NK/T-cell lymphoma (ENTKL). Among 158 patients with newly diagnosed stage I/II ENKTL, 61 patients were treated with sequential chemotherapy followed by radiotherapy (SCRT), 55 with concurrent chemoradiotherapy followed by non-anthracycline-based chemotherapy (CCRT/CT), and 42 with chemotherapy (CT) only. The 5-year overall survival (OS) rate did not differ between SCRT (77.7±5.5%) and CCRT/CT (68.9±6.8%; p=0.234). In the SCRT group, 18 patients (29.5%) relapsed within the RT field and 6 (9.8%) at systemic sites, while in the CCRT/CT group, 9 patients (16.4%) relapsed at the primary site and 14 (25.5%) at systemic sites. The 5-year cumulative incidence of relapse (CIR) at primary sites was 26.3% and 19.2% after SCRT and CCRT/CT (p=0.308), while the 5-year CIR of systemic sites was 8.7% and 26.5% after SCRT and CCRT/CT, respectively (p=0.010). In the multivariate analysis, NK/T-cell Prognostic Index score and CR achievement were the most important prognostic factors for survival. Although up-front RT had limitations in systemic disease control and was associated with an increased risk of systemic relapse during RT compared to SCRT, timing of RT did not significantly affect survival outcomes.
Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea.
Joon-Ho
JH
Moon
Division of Hematology, Department of Internal Medicine, St. Vincent's hospital, The Catholic University of Korea, Suwon, Republic of Korea.
Bo-Hee
BH
Lee
Division of Hematology, Department of Internal Medicine, St. Vincent's hospital, The Catholic University of Korea, Suwon, Republic of Korea.
Jeong-A
JA
Kim
Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea.
Yoo Jin
YJ
Lee
Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea.
Yee Soo
YS
Chae
Department of Hematology/Oncology, Chonbuk National University Hospital, Jeonju, Republic of Korea.
Ho-Young
HY
Yhim
Department of Hematology/Oncology, Chonbuk National University Hospital, Jeonju, Republic of Korea.
Jae-Yong
JY
Kwak
Department of Hematology/Oncology, Dongsan Medical Center, Daegu, Republic of Korea.
Young Rok
YR
Do
Department of Hematology/Oncology, Korea University College of Medicine, Seoul, Republic of Korea.
Yong
Y
Park
Department of Hematology-Oncology, Pusan National University Hospital, Pusan, Republic of Korea.
Moo-Kon
MK
Song
Department of Hematology-Oncology, Pusan National University Hospital, Pusan, Republic of Korea.
Ho-Jin
HJ
Shin
Department of Medical Science, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
Therasa
T
Kim
Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
Je-Jung
JJ
Lee
Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea. Electronic address: drydh1685@hotmail.com.
Deok-Hwan
DH
Yang
D000293:Adolescent; D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D004358:Drug Therapy; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011878:Radiotherapy; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
Chemotherapy; Extranodal NK/T cell lymphoma; Radiotherapy; Relapse