Radiotherapy As Primary Treatment for Stage IE and IIE Nasal Natural Killer/T-Cell Lymphoma

Li, Yexiong; Yao, Bo; Jin, Jing; Wang, Weihu; Liu, Yueping; Song, Yang; Wang, Shulian; Liu, Xin-Fan; Zhou, Liqiang; He, Xiaohong; Lü, Ning; Yu, Zi-Hao

doi:10.1200/jco.2005.03.2573

Cited by 316 publications

(336 citation statements)

References 59 publications

(47 reference statements)

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“…CHOP is regarded as the standard chemotherapy regimen for aggressive NHL, however, its effect in patients with extranodal NK/T-cell lymphoma, nasal type, is usually inferior. In the present study, a CR rate of 33% was achieved, which is consistent with previous literatures [8,18]; 35% of patients had PD during chemotherapy, suggesting primary drug-resistance may exist in some patients. P-gp, encoded by mdr-1 gene, has been extensively studied in various types of malignancies.…”

Section: Discussionsupporting

confidence: 93%

“…Patients with later stage are usually less likely to achieve CR. Moreover, for patients with limited stage, Stage II was proved to be an adverse prognostic factor by multivariate analysis in a retrospective study mentioned earlier [8].…”

Section: Discussionmentioning

confidence: 87%

“…In contrast with other types of aggressive non-Hodgkin's lymphoma (NHL), extranodal NK/T-cell lymphoma, nasal type, is less likely responsive to the doxorubicin-based chemotherapy regimens such as CHOP or dose-intense CHOP [6,7]. In one recent study for Stage I and II diseases, postchemotherapy complete response (CR) rate was only 20% [8]. On the contrary, a CR rate of 61% can be achieved by CHOP in patients with limited-stage aggressive NHL [9].…”

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical expression and clinical significance of P‐glycoprotein in previously untreated extranodal NK/T‐cell lymphoma, nasal type

Wang

et al. 2008

American J Hematol

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Overexpression of P-glycoprotein (P-gp) has been identified by a variety of methods in NK cells and NK malignancies. The aim of this study was to determine the clinical significance of P-gp in previously untreated extranodal NK/T-cell lymphoma, nasal type. Tumor specimens from 30 patients initially treated with CHOP or CHOP-based chemotherapy were examined by immunohistochemistry using JSB-1, a monoclonal antibody recognizing the intracellular epitope of P-gp molecule. Twenty cases (67%) were positive for P-gp expression. The complete response rate achieved in P-gp positive patients was significantly lower than in P-gp negative ones (20% vs. 60%, P = 0.045). With a median follow-up of 25 months, the 2-year progression-free survival (PFS) and overall survival (OS) rates for all patients were 66 and 69%, respectively. Compared with both PFS and OS rates of P-gp positive patients, those of P-gp negative patients showed a trend of benefit that did not reach statistical significance for borderline P values (PFS: 90% vs. 54%, P = 0.1057; OS: 90% vs. 61%, P = 0.2028). Our results suggest that P-gp expression is related with poor treatment outcomes of extranodal NK/T-cell lymphoma, nasal type. Am. J. Hematol. 83:795-799, 2008. V

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical expression and clinical significance of P‐glycoprotein in previously untreated extranodal NK/T‐cell lymphoma, nasal type

Wang

et al. 2008

American J Hematol

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“…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: 98%

“…3,26 A dose of 50 to 56 grays (Gy) was given to the primary tumor, and 15 patients received a boost of 5 to 10 Gy to residual disease. Patients were treated with 1.8 to 2.0 Gy daily, 5Â a week.…”

Section: Treatmentmentioning

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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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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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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Radiotherapy As Primary Treatment for Stage IE and IIE Nasal Natural Killer/T-Cell Lymphoma

Abstract: RT as primary therapy resulted in good outcome in early-stage disease, and the addition of CT to RT was not accompanied by an improvement in survival.

Cited by 316 publications

References 59 publications

Immunohistochemical expression and clinical significance of P‐glycoprotein in previously untreated extranodal NK/T‐cell lymphoma, nasal type

Immunohistochemical expression and clinical significance of P‐glycoprotein in previously untreated extranodal NK/T‐cell lymphoma, nasal type

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

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

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