Upfront radiation is essential for high-risk early-stage extranodal NK/T-cell lymphoma, nasal type: comparison of two sequential treatment modalities combining radiotherapy and GDP (gemcitabine, dexamethasone, and cisplatin) in the modern era. Issue 11 (19th September 2019)

• Record Type: Journal Article
• Authors: Qi, Fei; Chen, Bo; Wang, Jingjing; Lin, Xinyi; Qi, Shunan; Yang, Jianliang; Zhou, Shengyu; Wang, Shulian; Gui, Lin; Fang, Hui; Liu, Peng; Song, Yongwen; Yang, Sheng; Li, Yexiong; Dong, Mei
• Is Part Of: Leukemia & lymphoma. Volume 60:Issue 11(2019)
• Page Start: 2679
• Page End: 2688
• Publication Date: 2019-09-19
• Subjects: Extranodal NK/T-cell lymphoma -- radiotherapy -- chemotherapy -- treatment sequence; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2019.1599111
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Early/upfront radiation was associated with improved survivals compared with late radiation for early-stage NK/T-cell lymphoma (NKTCL) in the old era when anthracycline-base chemotherapy (CT) prevailed. However, in the modern era of effective l -asparaginase/gemcitabine-based CT, the optimal timing of radiation is unclear. In this study, 75 patients with newly diagnosed NKTCL, who were treated with combined involved-field intensity-modulated radiotherapy and GDP (gemcitabine, dexamethasone, and cisplatin) were retrospectively reviewed, including 45 from the RT + CT group and 30 from the CT + RT ± CT group. Compared with CT + RT ± CT, RT + CT sequence achieved superior progression-free survival (5-year PFS: 81.6% vs. 56.0%, p = .017) and locoregional control (LRC) (90.8% vs. 66.9%; p = .020). Responses, overall survivals or adverse event incidences did not differ across the groups. Upfront RT was a powerful prognostic variable for favorable PFS (HR 0.302; 95% CI: 0.125–0.729; p = .008). It indicated that upfront RT administration remains vital in enhancing LRC and survival for localized NKTCL in the modern era.