title: Extended Course and Increased Dose of Initial Chemotherapy for Extranodal Nasal Type Natural Killer/T (NK/T)-Cell Lymphoma in Patients <60 Years Old: A Single-Center Retrospective Cohort Study.
abstract: BACKGROUND Extranodal NK/T-cell lymphoma (ENKTL) of the nasal type is highly invasive and relatively resistant to chemotherapy. This study aimed to assess the efficacy and safety of an extended chemotherapy regimen with increased dose intensity. MATERIAL AND METHODS This was a retrospective cohort study of 69 patients <60 years old with an ECOG score 0-2 treated for ENKTL at the Second Affiliated Hospital of Xi'an Jiaotong University between January 2004 and December 2013. The outcomes were compared between patients who received >8 courses of high-intensity chemotherapy (n=37) vs. 6-8 courses (n=18) and <6 courses (n=14) of conventional chemotherapy. Regimens included improved CHOP, CHOP-E, EPOCH, MAED, MMED, SMILE, and Hyper-CVAD with an increased dose intensity in the >8 courses group. RESULTS The mean follow-up was 52 months (8 to 82 months). Remission rate did not differ significantly when compared among the 3 groups after 3 courses of chemotherapy (83.8%, 77.8%, and 78.6%, respectively, overall P=0.834), but the 5-year overall survival (OS) differed significantly (63.5%, 45.1%, and 22.9%, respectively, overall P=0.030), as did progression-free survival (PFS) (59.1%, 36.0%, and 15.1%, respectively, overall P=0.020), disease-free survival (DFS) (54.1%, 35.5%, and 12.9%, respectively, overall P=0.022), and total relapse rate throughout follow-up (37.04%, 50.0%, and 88.89%, respectively, overall P=0.027). There were no differences in adverse effects among the 3 groups. CONCLUSIONS These results suggest improved OS, PFS, DFS, and relapse rate in young patients with ENKTL receiving >8 courses of high-intensity chemotherapy.
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Wanggang
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Xingmei
authors.initials: X
authors.lastname: Cao
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Aili
authors.initials: A
authors.lastname: He
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Yinxia
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Liufang
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Bo
authors.initials: B
authors.lastname: Lei
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Pengyu
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland).
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies
keywords: Drug Therapy; Lymphoma, Extranodal NK-T-Cell; Survival