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

Title
Sequential chemotherapy/radiotherapy was comparable with concurrent chemoradiotherapy for stage I/IINK/T-cell lymphoma
Authors
Kwong, Y. L.Kim, S. J.Tse, E.Oh, S. Y.Kwak, J. Y.Eom, H. S.Do, Y. R.Mun, Y. C.Lee, S. R.Shin, H. J.Suh, C.Chuang, S. S.Lee, Y. S.Lim, S. T.Izutsu, K.Suzuki, R.Relander, T.d'Amore, F.Schmitz, N.Jaccard, A.Kim, W. S.
Ewha Authors
문영철
SCOPUS Author ID
문영철scopus
Issue Date
2018
Journal Title
ANNALS OF ONCOLOGY
ISSN
0923-7534JCR Link1569-8041JCR Link
Citation
vol. 29, no. 1, pp. 256 - 263
Keywords
stage I/IINK/T-cell lymphomasconcurrent chemoradiotherapysequential chemotherapy and radiotherapy
Publisher
OXFORD UNIV PRESS
Indexed
SCI; SCIE; SCOPUS WOS
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/IINK/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 CTthornRT gave similar outcome.
DOI
10.1093/annonc/mdx684
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의과대학 > 의학과 > Journal papers
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