The Roles of Radiotherapy and Chemotherapy in the Era of Multimodal Treatment for Early-Stage Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma.
10.3349/ymj.2016.57.4.846
- Author:
Tae Hyung KIM
1
;
Jin Seok KIM
;
Yang Gun SUH
;
Jaeho CHO
;
Woo Ick YANG
;
Chang Ok SUH
Author Information
1. Department of Radiation Oncology, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. cosuh317@yuhs.ac
- Publication Type:Original Article
- Keywords:
Lymphoma;
radiotherapy;
recurrencec
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use;
*Chemoradiotherapy;
Combined Modality Therapy;
Disease-Free Survival;
Female;
Humans;
Lymphoma, Extranodal NK-T-Cell/*drug therapy/mortality/*radiotherapy;
Male;
Middle Aged;
Retrospective Studies;
Survival Rate;
Treatment Outcome;
Young Adult
- From:Yonsei Medical Journal
2016;57(4):846-854
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate radiotherapy (RT) and chemotherapy (CT) treatments of early-stage extranodal natural killer/T-cell lymphoma (ENKTL). MATERIALS AND METHODS: Fifty-five patients with stage I or II ENKTL [n=39 (71%) and 16 (29%) patients, respectively] who were treated with RT between 1999 and 2013 were analyzed retrospectively. The median age was 54 years (range, 24-81). Patients were grouped by treatment modality as RT alone [n=19 (35%)], upfront CT plus RT [CT+RT, n=16 (29%)], and concurrent chemoradiotherapy [CCRT, n=20 (36%)]. The median RT dose was 48 Gy. Patient characteristics between each treatment group were well balanced. Patterns of failure and survival were analyzed. RESULTS: The overall response rate after RT was 94.6%. Ten patients experienced distant failure, and seven experienced local failure comprising five in-field and two out-field failures. The local and distant failure rates in the RT-alone group were the same (16%). In the CT+RT group, the most common failure sites were local (19%). In the CCRT group, the most common failures were distant (25%). At a median follow-up of 56 months (range, 1-178 months), the 5-year overall survival (OS) and progression-free survival rates were 66% and 54%, respectively. The 5-year OS rate for the RT-alone and CT+RT groups were 76% and 69%, respectively, and the 2-year OS rate for the CCRT group was 62% (p=0.388). CONCLUSION: In the era of multimodal treatment for ENKTL, RT alone using advanced techniques should be considered for local disease control, whereas maintenance CT regimens should be considered for distant disease control.
