Comparative Study of L-Asparaginase-Based LOP Regimen Over CHOP Regimen Before Radiotherapy for Stage IIE Extranodal Nasal Type NK/T Cell Lymphoma: A Study of 2 Centers

Huang, Lv‐Yin; Yuan, Bin; H, Wu; Chu, Hongliang; Liu, Yayun; Wu, Shuang; Li, Hong; Lű, He; Chen, Hui

doi:10.1016/j.clml.2016.12.003

Cited by 17 publications

(15 citation statements)

References 28 publications

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“…CHOP and CHOP-like regimens have proved to be ineffective for ENKTL patients with high recurrence rates and short survival times 10 , 11 , 13 . Furthermore, several studies 37 - 39 have demonstrated that L-asparaginase/pegaspargase-based regimens are superior to traditional CHOP or CHOP-like regimens in terms of response rates and survival outcomes. The recommended treatment for limited-stage ENKTL is radiotherapy combined with L-asparaginase/pegaspargase-based chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

A Multicenter Retrospective Comparison of Sequential versus Sandwich Chemoradiotherapy for Stage IE-IIE Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type

Li¹,

Li²,

Zhong³

et al. 2018

J. Cancer

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Background: Chemotherapy and radiotherapy are critical for treating early-stage extranodal natural killer/T-cell lymphoma, nasal type (ENKTL); however, the optimal therapy sequence remains unclear. Therefore, we performed this study to compare the efficacy of L-asparaginase/pegaspargase-based sequential versus sandwich chemoradiotherapy for patients newly diagnosed with stage IE-IIE ENKTL.Methods: Patients were categorized into sequential (N = 111) and sandwich (N = 104) groups. Chemotherapy regimens included GELOX, SMILE, and VLP. The median radiotherapy dose was 55.0 Gy (range, 40.0-63.0 Gy). Adverse events, treatment responses, and survival outcomes were analyzed.Results: Patients' clinical characteristics were largely comparable between the 2 groups; however, the sandwich group comprised a larger number of Ann Arbor stage IIE patients. Local invasion was the most significant predictor of overall survival (OS); local invasion and Ann Arbor stage were significant predictors of progression-free survival (PFS). There were no significant differences in the complete response rate (85.6% vs. 89.4%, p = 0.396), 3-year OS (77.5% vs. 80.8%, p = 0.636), or 3-year PFS rates (74.8% vs. 76.9%, p = 0.806) in the sequential vs. sandwich groups, respectively. The incidence of grade 3/4 hematological toxicities was higher in the sandwich group than in the sequential group (27.9% vs. 15.3%, respectively, p = 0.025). The response rates and survival outcomes in stage IE and IIE patients did not differ between sequential and sandwich groups.Conclusions: In the era of L-asparaginase/pegaspargase, both sequential and sandwich chemoradiotherapy are safe and similarly effective in patients with newly diagnosed stage IE-IIE ENKTL.

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Section: Discussionmentioning

confidence: 99%

A Multicenter Retrospective Comparison of Sequential versus Sandwich Chemoradiotherapy for Stage IE-IIE Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type

Li¹,

Li²,

Zhong³

et al. 2018

J. Cancer

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“…Another recent retrospective study from Huang et al [ 27 ] compared the efficacy between the “sandwich” LVD regimen and the ‘sandwich’ CHOP regimen in 80 Asiatic patients with stage II ENKTCL. They found a statistical difference between objective response rates in patients treated with LVD (89.6%) and CHOP (65.6%; P =0.009).…”

Section: Discussionmentioning

confidence: 99%

“…The impact of radiotherapy is also confirmed by our results. No matter which chemotherapeutic regimen was offered, the combined modality is of great use in this particular type of lymphoma in terms of response rates and survival in early stages [ 5 6 18 27 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of L-asparaginase-based regimens compared to anthracycline-based regimens in newly diagnosed extranodal NK/T-cell lymphoma, nasal type: a single Mexican center experience

et al. 2018

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BackgroundExtranodal NK/T-cell lymphoma, nasal type (ENKTCL) has a high prevalence in Asia and Latin American countries, such as Mexico, where it encompasses 40% of all T-cell non-Hodgkin lymphomas. Historically, responses to anthracycline-based therapies have been disappointing. Since data about the effectiveness of L-asparaginase-based regimens in Mexico are limited, we compared both therapies in our center.MethodsWe performed a retrospective cohort of patients with newly diagnosed ENKTCL, who were divided into two groups for treatment and analysis (group 1: L-asparaginase-based regimen and group 2: anthracycline-based regimen) between 2001 and 2016.ResultsOf 36 patients with newly-diagnosed ENKTCL, 33 received at least one cycle of chemotherapy (22 in group 1 and 11 in group 2). Over a median follow-up interval of 17 months (range, 0–167), a complete response (CR) was observed in 45.5% of patients in group 1, compared to 27% of group 2 (P=0.45). Progression was more frequently observed in group 2 than in group 1 (54.5% vs. 18.4%, P=0.04). The median overall survival (OS) was 44 months in group 1, compared to 5 months in group 2 (P=0.012). The multivariate analysis showed that failure to achieve a CR after first-line therapy was the only significant factor for OS (HR, 3.04; 95% CI, 1.4–6.5; P=0.005).ConclusionL-asparaginase-based regimens for patients with newly-diagnosed ENKTCL confer a survival advantage over anthracycline-based regimens.

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“…Even for early stage diseases, which represent more than 70% of cases, the extranodal natural killer/T-cell lymphoma, nasal type (ENKL) is an aggressive subtype of non-Hodgkin lymphoma (NHL) with variable primary tumor positions, clinical symptoms, and patient prognosis. [1][2][3] The 5-year overall survival (OS) rates can vary from 40% to 90% for early stage ENKL 2,[4][5][6][7] ; the National Comprehensive Cancer Network recommendation, radiotherapy (RT) combined with chemotherapy (CT), is generally used clinically as a treatment strategy for ENKL. However, neither an optimal treatment strategy nor a valuable prognostic index has been identified.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Nomogram for Overall Survival in Early Stage Extranodal Natural Killer/T Cell Lymphoma Treated With High-Dose Radiotherapy

Wang

et al. 2020

Clinical Lymphoma Myeloma and Leukemia

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The prognostic system for early stage extranodal natural killer/T-cell lymphoma, nasal-type (ENKL) treated with high-dose radiotherapy (RT) remains unclear. We developed a nomogram including 4 variables in 81 early ENKL patients treated with high-dose RT. This nomogram could predict 5-year overall survival accurately, which provides a meaningful risk estimate for early ENKL. Background: The aim of this study was to develop a prognostic nomogram for early stage extranodal natural killer/ T-cell lymphoma, nasal type (ENKL) treated with high-dose radiotherapy (RT). Patients and Methods: A total of 81 patients at 2 cancer centers with stage I to IIE ENKL who received chemotherapy (CT) and high-dose RT were retrospectively analyzed. The development of the nomogram was on the basis of the Cox proportional hazards model. We implemented the concordance index (C-index) and performed a calibration curve to determine its predictive and discriminatory capacity and compared our nomogram with the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI). Results: The nomogram included 4 important variables and used a multivariate analysis: lactate dehydrogenase, primary tumor invasion, tumor response, and CT regimen. The 5-year OS rate and progression-free survival were 64.7% and 57.5%, respectively for the entire group. The C-index of the nomogram for overall survival (OS) prediction was 0.87, and it was superior to the predictive power of the IPI and KPI. The calibration curve showed that the nomogram accurately predicted the 5-year OS. Conclusion: The proposed nomogram could provide an individualized risk estimate of the OS for early stage ENKL treated with CT and high-dose RT.

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Comparative Study of L-Asparaginase-Based LOP Regimen Over CHOP Regimen Before Radiotherapy for Stage IIE Extranodal Nasal Type NK/T Cell Lymphoma: A Study of 2 Centers

Cited by 17 publications

References 28 publications

A Multicenter Retrospective Comparison of Sequential versus Sandwich Chemoradiotherapy for Stage IE-IIE Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type

A Multicenter Retrospective Comparison of Sequential versus Sandwich Chemoradiotherapy for Stage IE-IIE Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type

Effectiveness of L-asparaginase-based regimens compared to anthracycline-based regimens in newly diagnosed extranodal NK/T-cell lymphoma, nasal type: a single Mexican center experience

Prognostic Nomogram for Overall Survival in Early Stage Extranodal Natural Killer/T Cell Lymphoma Treated With High-Dose Radiotherapy

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