Y L Kwong1, S J Kim2, E Tse1, S Y Oh3, J Y Kwak4, H S Eom5, Y R Do6, Y C Mun7, S R Lee8, H J Shin9, C Suh10, S S Chuang11, Y S Lee12, S T Lim13, K Izutsu14, R Suzuki15, T Relander16, F d'Amore17, N Schmitz18, A Jaccard19, W S Kim2. 1. Department of Medicine, Queen Mary Hospital, Hong Kong, China. 2. Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3. Department of Medicine, Dong-A University Medical Center, Busan, Korea. 4. Chonbuk National University Medical School, Jeonju, Korea. 5. National Cancer Center, Seoul, Korea. 6. Department of Medicine, Keimyung University Dongsan Medical Center, Deagu, Korea. 7. Ewha Womans University Mokdong Hospital, Seoul, Korea. 8. Department of Medicine, Korea University Ansan Hospital, Ansan, Korea. 9. Pusan National University Hospital, Pusan, Korea. 10. Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 11. Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan. 12. Department of Haematology, Singapore General Hospital, Singapore. 13. National Cancer Centre, Singapore. 14. Toranomon Hospital, Tokyo, Japan. 15. Department of Hematology and Oncology, Shimane University Cancer Center, Izumo, Japan. 16. Department of Oncology, Skane University Hospital, Lund, Sweden. 17. Department of Hematology, Aarhus University Hospital, Aarhus, Denmark. 18. Department of Hematology, Oncology and Stem Cell Transplantation, Asklepios Hospital St. Georg, Hamburg, Germany. 19. Department of Hematology, Centre Hospitalier Universitaire (CHU) Limoges, Limoges, France.
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.
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: Won Seog Kim; Yasuhiro Oki; Seok Jin Kim; Sang Eun Yoon; Kirit M Ardeshna; Yi Lin; Jia Ruan; Pierluigi Porcu; Jonathan E Brammer; Eric D Jacobsen; Dok Hyun Yoon; Cheolwon Suh; Felipe Suarez; John Radford; Lihua E Budde; Jin Seok Kim; Emmanuel Bachy; Hun Ju Lee; Catherine M Bollard; Arnaud Jaccard; Hye Jin Kang; Shannon Inman; Maryann Murray; Katherin E Combs; Daniel Y Lee; Ranjana Advani; Kurt C Gunter; Cliona M Rooney; Helen E Heslop Journal: Ann Hematol Date: 2021-07-24 Impact factor: 3.673
Authors: X Zheng; X He; Y Yang; X Liu; L L Zhang; B L Qu; Q Z Zhong; L T Qian; X R Hou; X Y Qiao; H Wang; Y Zhu; J Z Cao; J X Wu; T Wu; S Y Zhu; M Shi; L M Xu; H L Zhang; H Su; Y Q Song; J Zhu; Y J Zhang; H Q Huang; Y Wang; F Chen; L Yin; S N Qi; Y X Li Journal: ESMO Open Date: 2021-07-06