Radiotherapy and PGEMOX/GELOX regimen improved prognosis in elderly patients with early-stage extranodal NK/T-cell lymphoma

Abstract

The optimal treatment strategy for elderly patients with natural killer/T-cell lymphoma (NKTCL) remains to be established. A total of 63 elderly patients with newly diagnosed NKTCL were retrospectively reviewed. Among the patients with stage I-II disease, 58.3 % received radiotherapy (RT) ± chemotherapy, and 41.7 % received chemotherapy alone. Compared with chemotherapy alone, RT ± chemotherapy elicited a significantly higher overall response rate (ORR) (100 vs. 57.1 %, P < 0.001) and substantially prolonged 5-year overall survival (OS) (55.3 vs. 18.0 %, P < 0.001) in patients with stage I-II disease. Compared with other chemotherapeutic regimens, pegaspargase plus gemcitabine and oxaliplatin (PGEMOX)/L-asparaginase plus gemcitabine and oxaliplatin (GELOX) was associated with a significantly higher ORR (92.9 vs. 51.6 %, P = 0.009) and a significantly improved 5-year OS (78.6 vs. 23.9 %, P = 0.010) in patients with stage I-II disease. Nine patients with stage I-II disease who were treated with PGEMOX/GELOX followed by RT had an encouraging outcome (5-year OS 100 %, 5-year progression-free survival (PFS) 85.7 %), which was superior to that of patients receiving other regimens followed by RT. In conclusion, RT played an important role for elderly patients with early-stage NKTCL, and the PGEMOX/GELOX regimen was superior to other regimens. The combination of them may be a promising treatment option.

Concurrent Etoposide, Steroid, High-dose Ara-C and Platinum chemotherapy with radiation therapy in localised extranodal natural killer (NK)/T-cell lymphoma, nasal type

“…Some experts recently stopped using the standard first-line CHOP in this entity, preferring a more efficient non-multidrug-resistant regimen [2,33]. Among the novel non-multidrug-resistant regimens, those containing asparaginase have elicited promising responses [9][10][11][12][13] even in elderly patients [34], which means that this agent could be considered in CCRT strategies.…”

NCCN Guidelines Insights: T-Cell Lymphomas, Version 2.2018

“…3,[18][19][20][21][22][23][24] In an analysis of the International Peripheral TCell Lymphoma Project, which retrospectively reviewed the clinical outcomes of 136 patients with …”

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)

“…Our previous studies using a small number of NKTCL cases at a single institution revealed favorable outcomes for children and adolescents but unfavorable prognoses for elderly patients . However, the prognostic significance and treatment outcome of elderly patients with NKTCL have not been established in large, multicenter studies …”