skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Risk‐based, response‐adapted therapy for early‐stage extranodal nasal‐type NK /T‐cell lymphoma in the modern chemotherapy era: A China Lymphoma Collaborative Group study

Journal Article · · American Journal of Hematology
DOI:https://doi.org/10.1002/ajh.25878· OSTI ID:1638759
ORCiD logo [1];  [1];  [2];  [3];  [4];  [5];  [6];  [6];  [7];  [8];  [9];  [9];  [10];  [11];  [12];  [13];  [14];  [15];  [16];  [17] more »;  [18];  [19];  [19];  [20];  [21];  [21];  [22];  [1] « less
  1. Department of Radiation Oncology National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) Beijing China
  2. Department of Radiation Oncology State Key Laboratory of Oncology in South China, Sun Yat‐sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine Guangzhou China
  3. Department of Medical Oncology Sun Yat‐sen University Cancer Center China
  4. Department of Radiation Oncology Chongqing University Cancer Hospital &, Chongqing Cancer Hospital Chongqing China
  5. Department of Radiation Oncology Jiangsu Cancer Hospital &, Jiangsu Institute of Cancer Research Nanjing China
  6. Department of Oncology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
  7. Department of Radiation Oncology The General Hospital of Chinese People's Liberation Army Beijing China
  8. Department of Radiation Oncology The Affiliated Provincial Hospital of Anhui Medical University Hefei China
  9. Department of Radiation Oncology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) Beijing China
  10. Department of Radiation Oncology The Fourth Hospital of Hebei Medical University Shijiazhuang China
  11. Department of Radiation Oncology Second Affiliated Hospital of Nanchang University Nanchang China
  12. Department of Radiation Oncology Beijing Hospital, National Geriatric Medical Center Beijing China
  13. Department of Radiation Oncology Zhejiang Cancer Hospital, Hangzhou Zhejiang China
  14. Department of Radiation Oncology Shanxi Cancer Hospital and the Affiliated Cancer Hospital of Shanxi Medical University Taiyuan China
  15. Department of Radiation Oncology Fujian Provincial Cancer Hospital Fuzhou China
  16. Department of Radiation Oncology Affiliated Hospital of Guizhou Medical University, Guizhou Cancer Hospital Guiyang China
  17. Department of Radiation Oncology Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine Changsha China
  18. Department of Radiation Oncology Xijing Hospital of Fourth Military Medical University Xi'an China
  19. Department of Radiation Oncology Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute &, Hospital, National Clinical Research Center for Cancer Tianjin China
  20. Department of Oncology The Fifth Medical Center of PLA General Hospital Beijing China
  21. Department of Medical Oncology Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital &, Institute Beijing China
  22. Division of Biostatistics and Bioinformatics Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine Baltimore Maryland USA
+ Show Author Affiliations

Abstract We aimed to determine the survival benefits of chemotherapy (CT) added to radiotherapy (RT) in different risk groups of patients with early‐stage extranodal nasal‐type NK/T‐cell lymphoma (ENKTCL), and to investigate the risk of postponing RT based on induction CT responses. A total of 1360 patients who received RT with or without new‐regimen CT from 20 institutions were retrospectively reviewed. The patients had received RT alone, RT followed by CT (RT + CT), or CT followed by RT (CT + RT). The patients were stratified into different risk groups using the nomogram‐revised risk index (NRI). A comparative study was performed using propensity score‐matched (PSM) analysis. Adding new‐regimen CT to RT (vs RT alone) significantly improved overall survival (OS, 73.2% vs 60.9%, P  < .001) and progression‐free survival (PFS, 63.5% vs 54.2%, P  < .001) for intermediate‐risk/high‐risk patients, but not for low‐risk patients. For intermediate‐risk/high‐risk patients, RT + CT and CT + RT resulted in non‐significantly different OS (77.7% vs 72.4%; P = .290) and PFS (67.1% vs 63.1%; P = .592). For patients with complete response (CR) after induction CT, initiation of RT within or beyond three cycles of CT resulted in similar OS (78.2% vs 81.7%, P = .915) and PFS (68.2% vs 69.9%, P = .519). For patients without CR, early RT resulted in better PFS (63.4% vs 47.6%, P = .019) than late RT. Risk‐based, response‐adapted therapy involving early RT combined with CT is a viable, effective strategy for intermediate‐risk/high‐risk early‐stage patients with ENKTCL in the modern treatment era.

Sponsoring Organization:
USDOE
OSTI ID:
1638759
Journal Information:
American Journal of Hematology, Journal Name: American Journal of Hematology Vol. 95 Journal Issue: 9; ISSN 0361-8609
Publisher:
Wiley Blackwell (John Wiley & Sons)Copyright Statement
Country of Publication:
United States
Language:
English
Citation Metrics:
Cited by: 19 works
Citation information provided by
Web of Science

References (40)

Clinical impact of induction treatment modalities and optimal timing of radiotherapy for the treatment of limited-stage NK/T cell lymphoma journal October 2016
Effect of primary tumor invasion on treatment and survival in extranodal nasal-type NK/T-cell lymphoma in the modern chemotherapy era: a multicenter study from the China Lymphoma Collaborative Group (CLCG) journal May 2019
The Roles of Radiotherapy and Chemotherapy in the Era of Multimodal Treatment for Early-Stage Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma journal January 2016
Risk-adapted therapy for early-stage extranodal nasal-type NK/T-cell lymphoma: analysis from a multicenter study journal September 2015
SMILE for natural killer/T-cell lymphoma: analysis of safety and efficacy from the Asia Lymphoma Study Group journal October 2012
Risk-dependent curability of radiotherapy for elderly patients with early-stage extranodal nasal-type NK/T-cell lymphoma: A multicenter study from the China Lymphoma Collaborative Group (CLCG) journal October 2018
The impact of the omission or inadequate dosing of radiotherapy in extranodal natural killer T-cell lymphoma, nasal type, in the United States: Treatment Selection for NK T-Cell Lymphoma journal April 2017
simPH : An R Package for Illustrating Estimates from Cox Proportional Hazard Models Including for Interactive and Nonlinear Effects journal January 2015
Radiotherapy is essential after complete response to asparaginase-containing chemotherapy in early-stage extranodal nasal-type NK/T-cell lymphoma: A multicenter study from the China Lymphoma Collaborative Group (CLCG) journal October 2018
Radiotherapy Alone With Curative Intent in Patients With Stage I Extranodal Nasal-Type NK/T-Cell Lymphoma journal April 2012
Prognostic nomogram for overall survival in previously untreated patients with extranodal NK/T-cell lymphoma, nasal-type: a multicenter study journal February 2015
The optimal timing of radiotherapy in the combined modality therapy for limited-stage extranodal NK/T cell lymphoma (ENKTL): a systematic review and meta-analysis journal August 2018
Radiotherapy improves survival in early stage extranodal natural killer/T cell lymphoma patients receiving asparaginase-based chemotherapy journal December 2016
Immunophenotypic and Clinical Differences Between the Nasal and Extranasal Subtypes of Upper Aerodigestive Tract Natural Killer/T-Cell Lymphoma journal March 2014
Radiotherapy As Primary Treatment for Stage IE and IIE Nasal Natural Killer/T-Cell Lymphoma journal January 2006
Survival outcomes of patients with extranodal natural-killer T-cell lymphoma: a prospective cohort study from the international T-cell Project journal April 2020
Early stage nasal NK/T-cell lymphoma: clinical outcome, prognostic factors, and the effect of treatment modality journal September 2002
Risk-Dependent Conditional Survival and Failure Hazard After Radiotherapy for Early-Stage Extranodal Natural Killer/T-Cell Lymphoma journal March 2019
Treatments and Outcomes of Patients With Extranodal Natural Killer/T-Cell Lymphoma Diagnosed Between 2000 and 2013: A Cooperative Study in Japan journal January 2017
Phase 2 trial of “Sandwich” L -asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma: LVP and RT for Nasal NK/T-Cell Lymphoma journal December 2011
Effect of age as a continuous variable on survival outcomes and treatment selection in patients with extranodal nasal-type NK/T-cell lymphoma from the China Lymphoma Collaborative Group (CLCG) journal October 2019
Validation of nomogram-revised risk index and comparison with other models for extranodal nasal-type NK/T-cell lymphoma in the modern chemotherapy era: indication for prognostication and clinical decision-making journal March 2020
Risk-adapted survival benefit of IMRT in early-stage NKTCL: a multicenter study from the China Lymphoma Collaborative Group journal September 2018
Phase 2 Study of First-line Intensity Modulated Radiation Therapy Followed by Gemcitabine, Dexamethasone, and Cisplatin for High-Risk, Early Stage Extranodal Nasal-Type NK/T-Cell Lymphoma: The GREEN Study journal September 2018
A systematic comparison of treatment modalities for nasal extranodal natural killer/T-cell lymphoma in early stages between concurrent chemoradiotherapy and sequential chemotherapy journal January 2017
Sequential chemotherapy/radiotherapy was comparable with concurrent chemoradiotherapy for stage I/II NK/T-cell lymphoma journal January 2018
Early or Up-Front Radiotherapy Improved Survival of Localized Extranodal NK/T-Cell Lymphoma, Nasal-Type in the Upper Aerodigestive Tract journal January 2008
Upfront radiation is essential for high-risk early-stage extranodal NK/T-cell lymphoma, nasal type: comparison of two sequential treatment modalities combining radiotherapy and GDP (gemcitabine, dexamethasone, and cisplatin) in the modern era journal July 2019
Burden of lymphoma in China, 2006–2016: an analysis of the Global Burden of Disease Study 2016 journal November 2019
Phase II Trial of Concurrent Radiation and Weekly Cisplatin Followed by VIPD Chemotherapy in Newly Diagnosed, Stage IE to IIE, Nasal, Extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma Study journal December 2009
Modern Radiation Therapy for Extranodal Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group journal May 2015
Local tumor invasiveness is more predictive of survival than International Prognostic Index in stage IE/IIE extranodal NK/T-cell lymphoma, nasal type journal December 2005
Phase I/II Study of Concurrent Chemoradiotherapy for Localized Nasal Natural Killer/T-Cell Lymphoma: Japan Clinical Oncology Group Study JCOG0211 journal November 2009
Failure patterns and clinical implications in early stage nasal natural killer/T-cell lymphoma treated with primary radiotherapy journal April 2011
First-line combination of gemcitabine, oxaliplatin, and L-asparaginase (GELOX) followed by involved-field radiation therapy for patients with stage IE/IIE extranodal natural killer/T-cell lymphoma: GELOX in the Treatment of ENKTL journal July 2012
Early radiotherapy has an essential role for improving survival in patients with stage I-II nasal-type of NK/T cell lymphoma treated with l-asparaginase-containing chemotherapy—a single institution experience journal November 2014
Mortality of lymphoma and myeloma in China, 2004–2017: an observational study journal March 2019
Association of Improved Locoregional Control With Prolonged Survival in Early-Stage Extranodal Nasal-Type Natural Killer/T-Cell Lymphoma journal January 2017
Primary radiotherapy showed favorable outcome in treating extranodal nasal-type NK/T-cell lymphoma in children and adolescents journal November 2009
Sequential chemotherapy followed by radiotherapy versus concurrent chemoradiotherapy in patients with stage I/II extranodal natural killer/T-cell lymphoma, nasal type journal January 2013

Similar Records

Early or Up-Front Radiotherapy Improved Survival of Localized Extranodal NK/T-Cell Lymphoma, Nasal-Type in the Upper Aerodigestive Tract
Journal Article · Tue Jan 01 00:00:00 EST 2008 · International Journal of Radiation Oncology, Biology and Physics · OSTI ID:1638759
+10 more
Management Trends and Outcomes for Stage I to II Mantle Cell Lymphoma Using the National Cancer Data Base: Ascertaining the Ideal Treatment Paradigm
Journal Article · Sun Nov 01 00:00:00 EDT 2015 · International Journal of Radiation Oncology, Biology and Physics · OSTI ID:1638759
+2 more
Salvage Treatment Improved Survival of Patients With Relapsed Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type
Journal Article · Wed Jul 01 00:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics · OSTI ID:1638759
+7 more

Related Subjects