Sequential chemotherapy/radiotherapy was comparable with concurrent chemoradiotherapy for stage I/II NK/T-cell lymphoma.

Abstract

Background:

In stage I/II natural killer (NK)/T-cell lymphoma, concurrent chemoradiotherapy (CCRT) had previously been shown to result in superior outcome compared with anthracycline-containing regimens, which have since been considered ineffective. The role of CCRT in comparison with approaches employing nonanthracycline-containing chemotherapy (CT) and sequential radiotherapy (RT) in such patients remains to be defined.

Patients and methods:

Three hundred and three untreated patients (207 men, 96 women; median age: 51, 18-86 years) with stage I/II NK/T-cell lymphoma who had received nonanthracycline-containing regimens were collected from an international consortium and retrospectively analyzed. Treatment included single modality (CT and RT), sequential modalities (CT + RT; RT + CT) and concurrent modalities (CCRT; CCRT + CT). The impact of clinicopathologic parameters and types of treatment on complete response (CR) rate, progression-free-survival (PFS) and overall-survival (OS) was evaluated.

Results:

For CR, stage (P = 0.027), prognostic index for NK/T-cell lymphoma (PINK) (P = 0.026) and types of initial treatment (P = 0.011) were significant prognostic factors on multivariate analysis. On Cox regression analysis, ECOG performance score (P = 0.021) and PINK-EBV DNA (PINK-E) (P = 0.002) significantly impacted on PFS; whereas ECOG performance score (P = 0.008) and stage (P < 0.001) significantly impacted on OS. For comparing CCRT ± CT and sequential CT + RT, CCRT ± CT patients (n = 190) were similar to sequential CT + RT patients (n = 54) in all evaluated clinicopathologic parameters except two significantly superior features (higher proportion of undetectable circulating EBV DNA on diagnosis and lower PINK-E scores). Despite more favorable pre-treatment characteristics, CCRT ± CT patients had CR rate, PFS and OS comparable with sequential CT + RT patients on multivariate and Cox regression analyses.

Conclusions:

In stage I/II NK/T-cell lymphomas, when effective chemotherapeutic regimens were used, CCRT and sequential CT + RT gave similar outcome.

• Authors: Y L Kwong, S J Kim, E Tse, S Y Oh, J Y Kwak, H S Eom, Y R Do, Y C Mun, S R Lee, H J Shin, C Suh, S S Chuang, Y S Lee, S T Lim, K Izutsu, R Suzuki, T Relander, F d'Amore, N Schmitz, A Jaccard, W S Kim
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 29 Issue 1 Pg. 256-263 (01 01 2018) ISSN: 1569-8041 [Electronic] England
• PMID: 29077846 (Publication Type: Comparative Study, Journal Article)
• Copyright: © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].

Topics

• Adolescent
• Adult
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Chemoradiotherapy
• Cohort Studies
• Drug Administration Schedule
• Female
• Humans
• Lymphoma, Extranodal NK-T-Cell (drug therapy, pathology, radiotherapy)
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Young Adult