Research Papers:
Radiotherapy improves survival in early stage extranodal natural killer/T cell lymphoma patients receiving asparaginase-based chemotherapy
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Abstract
Yi-Yang Li1,2,3,*, Ling-Ling Feng2,3,*, Shao-Qing Niu4, Han-Yu Wang2,3, Lu-Lu Zhang2,3, Liang Wang2,5, Zhong-Jun Xia2,5, Hui-Qiang Huang2,6, Yun-Fei Xia2,3, Yu-Jing Zhang2,3, Xi-Cheng Wang1
1Department of Oncology, the First affiliated Hospital of Guangdong Pharmaceutical University, Guangdong 510080, People’s Republic of China
2State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, People’s Republic of China
3Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, People’s Republic of China
4Department of Radiation Oncology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510060, People’s Republic of China
5Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 5100600, People’s Republic of China
6Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, People’s Republic of China
*These authors have contributed equally to this work
Correspondence to:
Xi-Cheng Wang, email: [email protected]
Yu-Jing Zhang, email: [email protected]
Keywords: extranodal natural killer/T cell lymphoma, non-Hodgkin lymphoma, asparaginase, radiotherapy, chemotherapy
Received: September 18, 2016 Accepted: November 23, 2016 Published: December 17, 2016
ABSTRACT
This study retrospectively investigated asparaginase-based chemotherapy treatment outcomes with or without radiotherapy in 143 patients with stage IE–IIE extranodal natural killer/T cell lymphoma (ENKTCL). All patients received a median of three cycles of asparaginase-based chemotherapy, while 121 patients received radiotherapy following the chemotherapy. The complete remission (CR) rate for all patients post-chemotherapy was 58.7%, and rose to 73.4% by the end of treatment. Patients who received radiotherapy achieved better survival outcomes than those who did not (89.7% vs. 49.0% for 2-year overall survival (OS), P<0.001; 86.8% vs. 37.4% for 2-year progression-free survival (PFS), P<0.001). Additionally, even patients who achieved CR post-chemotherapy exhibited differential survival rates with or without radiotherapy (90.8% vs. 60% for 2-year OS, P=0.006; 86.1% vs. 60% for 2-year PFS, P=0.044). Multivariate analysis revealed that radiotherapy was an independent factor favoring OS (HR=0.098, 95%CI=0.031–0.314, P=0.001) and PFS (HR=0.156, 95%CI=0.062–0.396, P=0.001). Thus, radiotherapy is recommended for stage IE–IIE ENKTCL patients treated with asparaginase-based chemotherapy, even in cases of CR following chemotherapy.
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