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

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Author(s)
Y. L. KwongS. J. KimE. TseS. Y. OhJ. Y. KwakH. S. EomY. R. DoY. C. MunS. R. LeeH. J. ShinC. SuhS. S. ChuangY. S. LeeS. T. LimK. IzutsuR. SuzukiT. RelanderF. d’AmoreN. SchmitzA. JaccardW. S. Kim
Keimyung Author(s)
Do, Young Rok
Department
Dept. of Internal Medicine (내과학)
Journal Title
Annals of Oncology
Issued Date
2018
Volume
29
Issue
1
Keyword
concurrent chemoradiotherapysequential chemotherapy and radiotherapystage I/II NK/T-cell lymphomas
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.
Keimyung Author(s)(Kor)
도영록
Publisher
School of Medicine (의과대학)
Citation
Y. L. Kwong et al. (2018). Sequential chemotherapy/radiotherapy was comparable with concurrent chemoradiotherapy for stage I/II NK/T-cell lymphoma. Annals of Oncology, 29(1), 256–263. doi: 10.1093/annonc/mdx684
Type
Article
ISSN
0923-7534
DOI
10.1093/annonc/mdx684
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41467
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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