Early stage nasal NK/T-cell lymphoma: clinical outcome, prognostic factors, and the effect of treatment modality

Cheung, Moon‐Tong; Chan, John K. C.; Lau, W.S.; Ngan, Roger Kc; Foo, William

doi:10.1016/s0360-3016(02)02916-4

Cited by 251 publications

(262 citation statements)

References 35 publications

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“…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: 68%

“…Although improved survival with combined modality therapy was observed in our previous study of early stage NK/T-cell lymphoma of Waldeyer's ring, 26 no study so far has shown significant benefit of adding chemotherapy to radiotherapy in early stage nasal NK/T-cell lymphoma or early stage NK/T-cell lymphoma of the upper aerodigestive tract. 3,14,15,[20][21][22]33,34 Although the regimens and number of chemotherapy cycles administered varied somewhat, most (85%) of our patients received 4 cycles of standard CHOP or CHOPlike regimens. With high LRC after radiotherapy, no survival benefit of additional chemotherapy was observed in these patients with early stage nasal NK/T-cell lymphoma.…”

Section: Discussionmentioning

confidence: 99%

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

Wang

et al. 2011

Cancer

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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.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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

Wang

et al. 2011

Cancer

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“…In initial studies, when used as the only treatment modality, complete responses were observed in 52-100 % of patients with a overall response rate between 77 and 100 %. [5,12,13] However the rates of systemic relapse were as high as 45 %. [5] Therefore it is not recommended to use radiotherapy alone in management of this disorder.…”

Section: Toxicitymentioning

confidence: 99%

“…[5,12,13] However the rates of systemic relapse were as high as 45 %. [5] Therefore it is not recommended to use radiotherapy alone in management of this disorder. Additionally the dose and radiation fields are important considerations.…”

Section: Toxicitymentioning

confidence: 99%

“…This disease is known for its predominant involvement of the nasopharynx, strong association with Epstein-Barr virus (EBV) and caries a poor prognosis with a 5 year cumulative probability of survival ranging from 30 to 40 %. [4,5] One of the postulated reasons is the high concentration of P-glycoprotein on natural killer (NK) cells which leads to multi-drug resistance, hence response to traditional anthracycline containing regimens is poor. Incorporation of drugs like L Asparginase which bypass the effect of P-glycoprotein has improved the outlook for this disease.…”

Section: Introductionmentioning

confidence: 99%

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NK/T Cell Lymphoma: A Tertiary Centre Experience

Arora

Mehta

Ravichandran

et al. 2016

Indian J Hematol Blood Transfus

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Extranodal NK/T-cell lymphoma (ENKTL), nasal type, is a rare type of non-Hodgkin lymphoma that is commonly seen in East Asian countries and is associated with Epstein-Barr virus infection. This is a retrospective study where we describe nine cases of ENKTL; nasal type diagnosed and treated at our center over a period of 2 years. These cases were analyzed retrospectively for clinical presentation (age, sex, site of involvement), immunophenotype, treatment, response and toxicity profile. Sino-nasal symptoms (blocked nose, headache, epistaxis, regurgitation) were the most common presenting complaints (n = 8). Almost 67 % (n = 6/9) of the cases were referred from Bhutan. Necrosis and angiocentricity were the commonest histological features. Depending on the stage of the disease patient were initially treated with chemotherapy (SMILE/CHOP) and Radiotherapy (IFRT). We describe our experience of management of ENKTL, where we observe that Bhutan could be endemic region for this rare tumour.

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Risk-Dependent Conditional Survival and Failure Hazard After Radiotherapy for Early-Stage Extranodal Natural Killer/T-Cell Lymphoma

Liu

Zhu

et al. 2019

JAMA Netw Open

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Early stage nasal NK/T-cell lymphoma: clinical outcome, prognostic factors, and the effect of treatment modality

Cited by 251 publications

References 35 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

NK/T Cell Lymphoma: A Tertiary Centre Experience

Risk-Dependent Conditional Survival and Failure Hazard After Radiotherapy for Early-Stage Extranodal Natural Killer/T-Cell Lymphoma

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