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Sequential chemotherapy/radiotherapy was comparable with concurrent chemoradiotherapy for stage I/IINK/T-cell lymphoma
- Sequential chemotherapy/radiotherapy was comparable with concurrent chemoradiotherapy for stage I/IINK/T-cell lymphoma
- 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
- SCOPUS Author ID
- Issue Date
- Journal Title
- ANNALS OF ONCOLOGY
- 0923-7534; 1569-8041
- vol. 29, no. 1, pp. 256 - 263
- stage I/IINK/T-cell lymphomas; concurrent chemoradiotherapy; sequential chemotherapy and radiotherapy
- OXFORD UNIV PRESS
- SCI; SCIE; SCOPUS
- 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.
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