Early or Up-Front Radiotherapy Improved Survival of Localized Extranodal NK/T-Cell Lymphoma, Nasal-Type in the Upper Aerodigestive Tract

Huang, Meijuan; Jiang, Yu; Liu, Weiping; Li, Zhiping; Li, Mei; Zhou, Lin; Xu, Yong; Yu, Chunhua; Qiu, Li; Peng, Feng; Liu, Jiyan; Luo, Feng; Lü, You

doi:10.1016/j.ijrobp.2007.05.073

Cited by 141 publications

(148 citation statements)

References 42 publications

Supporting

Mentioning

133

Contrasting

Unclassified

Order By: Relevance

“…Similar to our finding of 25.5% 5-year cumulative incidence of systemic failure, previous studies have shown that 10% to 30% of early stage NK/T-cell lymphoma patients receiving primary radiotherapy experience systemic failure. 10,13,18,19,23,28 Our data further showed that in both univariate and multivariate analysis, patients with stage II and paranasal extension are at higher risk of systemic failure than those with stage I and limited disease. However, it should be repeated that early stage patients treated with radiotherapy in this series achieved approximately 90% local or locoregional control, which is superior to the rate of 50% reported in other studies.…”

Section: Discussionsupporting

confidence: 66%

“…19,23 The high rate of LRF in previous studies can be explained by low doses of <50 Gy and small involved-field (gross tumor volume plus margin) irradiation, leading to a poor outcome. 10,21,22,29,30 Furthermore, although the majority of our patients developed disease progression or early relapse within 2 years, the late relapse after 5 years occurred occasionally, indicating the importance of long-term follow-up in these patients. 31,32 Our data show excellent outcomes in early stage I nasal NK/T-cell lymphoma treated with either radiotherapy alone or a combination of radiotherapy and chemotherapy; however, patients with stage II disease carry a Cancer relatively unfavorable prognosis.…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

Failure patterns and clinical implications in early stage nasal natural killer/T‐cell lymphoma treated with primary radiotherapy

Wang

et al. 2011

Cancer

View full text Add to dashboard Cite

BACKGROUND: This study aimed to evaluate the failure patterns and clinical implications in patients with early stage nasal natural killer (NK)/T-cell lymphoma treated with primary radiotherapy. METHODS: Two-hundred fourteen patients were included. There were 182 cases of stage I and 32 cases of stage II disease. Patients received radiotherapy alone (n ¼ 96) or radiotherapy and chemotherapy (n ¼ 118). The median dose was 50 grays, and most patients received doxorubicin-based chemotherapy. RESULTS: The 5-year overall survival (OS) and progression-free survival rates for all patients were 72% and 65%, respectively. Sixty-three patients experienced treatment failure. The 5-year cumulative incidences of locoregional, systemic, and overall failures were 12.0%, 25.5%, and 32.9%, respectively. Stage and paranasal extension were significant predictors for systemic failure. The 5-year cumulative incidence of systemic failure was 22.6% for stage I disease versus 42.7% for stage II disease (P < .001), and 16.9% for limited disease versus 30.4% for paranasal extension (P < .001), respectively. Adding chemotherapy to extended involved-field radiotherapy did not significantly decrease the systemic failure rate nor improve survival. The cumulative incidence of systemic failure and OS rate at 5 years were 24.1% and 74.4% for combined modality therapy compared with 28.5% (P ¼ 0.758) and 69.8% (P ¼ 0.529) for radiotherapy alone. A very low incidence of cervical lymph node or central nervous system relapse was observed. CONCLUSIONS: Patients with early stage nasal NK/T-cell lymphoma have excellent locoregional control and favorable prognosis with radiotherapy, but patients with stage II disease or paranasal extension are at high risk of systemic failure, emphasizing the importance of integration of optimal radiotherapy with innovative systemic therapy.

show abstract

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 67%

Failure patterns and clinical implications in early stage nasal natural killer/T‐cell lymphoma treated with primary radiotherapy

Wang

et al. 2011

Cancer

View full text Add to dashboard Cite

show abstract

“…The two prospective trials of concurrent chemoradiotherapy [10,11] had not selected patients having risk factors. As shown in Table 2, the baseline clinical characteristics are comparable among the patients included in the two major recent retrospective studies of localized nasal NKTCL [47,48] and those enrolled in the two prospective clinical trials of concurrent chemoradiotherapy [10,11]. This similarity may be due to the median age at diagnosis and performance status of ENKL being lower than in other aggressive lymphomas, such as diffuse large B-cell lymphoma.…”

Section: Current Recommendable Management Of Newly Diagnosed Localizementioning

confidence: 82%

Current and future management of NK/T-cell lymphoma based on clinical trials

Yamaguchi

2012

Int J Hematol

View full text Add to dashboard Cite

Recently reported results of well-designed prospective clinical trials for extranodal NK/T-cell lymphoma, nasal type (ENKL) have rapidly changed the management of ENKL. This review will focus on the evidence obtained from prospective clinical trials for ENKL and discuss the most highly recommended current management and future directions for the better management of ENKL. For patients with nasal NK/T-cell lymphoma of stage IE or contiguous stage IIE with cervical node involvement, concurrent chemoradiotherapy with radiotherapy (RT) and a two-thirds dose of DeVIC chemotherapy is recommended as a first-line treatment. To obtain the expected clinical outcome, performing RT following the same procedure as that reported is important. For the other patients with newly diagnosed ENKL, SMILE chemotherapy is recommended as an induction therapy. The Epstein-Barr virus DNA load in peripheral blood is useful for both prognostication and monitoring during the follow-up after treatment. Other L-asparaginasecontaining chemotherapies and chemotherapies containing non-multidrug resistance-related agents and etoposide are good options for elderly patients or patients with impaired organ function. As in the cases of other aggressive lymphomas, prospective clinical trials with adequate statistical considerations should be conducted to improve the prognosis of patients with ENKL.

show abstract

“…Of those who received radiotherapy alone, 69% of patients achieved a complete response (CR), while only 8% of those who received chemotherapy prior to radiotherapy achieved CR [Kim et al, 2001;Korht & Advani 2009]. Huang et al reported CR and 5-year overall survival (OS) rates of 100% in patients who received radiotherapy alone, while those who received chemotherapy (CHOP) alone had rates of 25% and 90%, respectively [Huang et al, 2008]. Li et al reported overall response in 85 of 87 (97.7%) patients with stage I UAT-ENKL who received radiotherapy with 50-56 Gy (standard is 50 Gy).…”

Section: Radiotherapymentioning

confidence: 99%

“…Comparing those who received ≥54 Gy versus <54 Gy, 5-year OS and disease-free survival (DFS) rates were higher with the former: 75% vs 46% and 60% vs 46%, respectively [Huang et al, 2008]. Systemic failure is shown in 25% to 30% of patients with stage II and II disease treated with radiotherapy alone.…”

Section: Radiotherapymentioning

confidence: 99%

Pediatric Natural Killer Cell Malignancy

Hashii¹

2011

Acute Leukemia - The Scientist's Perspective and Challenge

View full text Add to dashboard Cite

Early or Up-Front Radiotherapy Improved Survival of Localized Extranodal NK/T-Cell Lymphoma, Nasal-Type in the Upper Aerodigestive Tract

Cited by 141 publications

References 42 publications

Failure patterns and clinical implications in early stage nasal natural killer/T‐cell lymphoma treated with primary radiotherapy

Failure patterns and clinical implications in early stage nasal natural killer/T‐cell lymphoma treated with primary radiotherapy

Current and future management of NK/T-cell lymphoma based on clinical trials

Pediatric Natural Killer Cell Malignancy

Contact Info

Product

Resources

About