Sequential chemotherapy followed by radiotherapy versus concurrent chemoradiotherapy in patients with stage I/II extranodal natural killer/T-cell lymphoma, nasal type

Jieun Lee; Chul Yong Kim; Young Je Park; Nam Kwon Lee

doi:10.5045/br.2013.48.4.274

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Original Article

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Blood Res 2013; 48(4):

Published online December 31, 2013

https://doi.org/10.5045/br.2013.48.4.274

Sequential chemotherapy followed by radiotherapy versus concurrent chemoradiotherapy in patients with stage I/II extranodal natural killer/T-cell lymphoma, nasal type

Jieun Lee, Chul Yong Kim^*, Young Je Park, and Nam Kwon Lee

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Department of Radiation Oncology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.

Correspondence to : Correspondence to Chul Yong Kim M.D., Ph.D. Department of Radiation Oncology, Korea University Medical Center, 73, Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. Tel: +82-2-920-5516, Fax: +82-2-927-1419, kcyro@korea.ac.kr

Received: September 10, 2013; Revised: October 10, 2013; Accepted: November 14, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Abstract

Background

The purpose of this report is to summarize our clinical experience of patients with stage I/II extranodal natural killer (NK)/T-cell lymphoma, nasal type, treated using sequential chemotherapy followed by radiotherapy (SCRT) or concurrent chemoradiotherapy (CCRT).

Methods

Forty-three patients with stage I/II extranodal NK/T-cell lymphoma, nasal type, who received SCRT (16 patients) or CCRT (27 patients) were included in the present analysis.

Results

The median follow-up time was 39 months (range, 4-171 months) for all patients, 77 months (range, 4-171 months) for the SCRT group, and 31 months (range, 6-132 months) for the CCRT group. There were no statistically significant differences between the SCRT and CCRT groups with regard to the 3-year progression-free survival (PFS) (56% vs. 41%, P=0.823) and 3-year overall survival (OS) (75% vs. 59%, P=0.670). Univariate analysis revealed that patients with tumors confined to the nasal cavity and patients achieved complete remission had better PFS and OS rates, regardless of the treatment sequence. Multivariate analysis revealed that patients with tumors confined to the nasal cavity and patients aged ≤60 years had better OS rates.

Conclusion

The effect of SCRT and CCRT are similar in terms of survival outcomes of patients with stage I/II extranodal NK/T-cell lymphoma, nasal type. Our results show that tumors confined to the nasal cavity and an age ≤60 years were associated with a better prognosis.

Keywords Extranodal NK/T-cell lymphoma, Nasal type, Chemoradiotherapy, Treatment outcome

Article

Original Article

Blood Res 2013; 48(4): 274-281

Published online December 31, 2013 https://doi.org/10.5045/br.2013.48.4.274

Sequential chemotherapy followed by radiotherapy versus concurrent chemoradiotherapy in patients with stage I/II extranodal natural killer/T-cell lymphoma, nasal type

Jieun Lee, Chul Yong Kim^*, Young Je Park, and Nam Kwon Lee

Department of Radiation Oncology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.

Correspondence to:Correspondence to Chul Yong Kim M.D., Ph.D. Department of Radiation Oncology, Korea University Medical Center, 73, Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. Tel: +82-2-920-5516, Fax: +82-2-927-1419, kcyro@korea.ac.kr

Received: September 10, 2013; Revised: October 10, 2013; Accepted: November 14, 2013

Abstract

Background

Methods

Forty-three patients with stage I/II extranodal NK/T-cell lymphoma, nasal type, who received SCRT (16 patients) or CCRT (27 patients) were included in the present analysis.

Results

Conclusion

Keywords: Extranodal NK/T-cell lymphoma, Nasal type, Chemoradiotherapy, Treatment outcome

Abstract

Fig 1.

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Figure 1.

Comparison of progression-free survival between patients treated with sequential chemotherapy followed by radiotherapy (SCRT, dotted line) and those treated with concurrent chemoradiotherapy (CCRT, solid line) (P=0.823).

Blood Research 2013; 48: 274-281https://doi.org/10.5045/br.2013.48.4.274

Fig 2.

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Figure 2.

Comparison of overall survival between patients treated with sequential chemotherapy followed by radiotherapy (SCRT, dotted line) and those treated with concurrent chemoradiotherapy (CCRT, solid line) (P=0.670).

Blood Research 2013; 48: 274-281https://doi.org/10.5045/br.2013.48.4.274

Table 1 . Patient characteristics..

^a)Student t-test, ^b)Pearson χ² test, or Fisher exact test. Data are presented as number of patients (%) unless otherwise indicated..

Abbreviations: SCRT, sequential chemotherapy followed by radiotherapy; CCRT, concurrent chemoradiotherapy; ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; IPI, International Prognostic Index; NKPI, natural killer/T cell Prognostic Index..

Table 2 . Treatment failure, survival outcomes, and follow-up results for sequential chemotherapy followed by radiotherapy (SCRT) group..

Abbreviations: PFS, progression-free survival; OS, overall survival; LR, local recurrence; NED, no evidence of disease; PNS, paranasal sinus; DOD, died of disease; DM, distant metastasis..

Table 3 . Treatment failure, survival outcomes, and follow-up results for the concurrent chemoradiotherapy (CCRT) group..

Abbreviations: PFS, progression-free survival; OS, overall survival; LR, local recurrence; NED, no evidence of disease; DOC, died of complication; DM, distant metastasis; DOD, died of disease; LRR, locoregional recurrence; RR, regional recurrence; PNS, paranasal sinus; Tx, treatment..

Table 4 . Univariate analysis of clinical variables associated with progression-free survival and overall survival for all patients (N=43)..

^a)Log-rank test..

Abbreviations: PFS, progression-free survival; OS, overall survival; SCRT, sequential chemotherapy followed by radiotherapy; CCRT, concurrent chemoradiotherapy; LDH, lactate dehydrogenase; IPI, International Prognostic Index; NKPI, natural killer/T cell Prognostic Index..