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Intensity-modulated radiation therapy followed by GDP chemotherapy for newly diagnosed stage I/II extranodal natural killer/T cell lymphoma, nasal type

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Abstract

Extranodal natural killer (NK)/T cell lymphoma, nasal type (ENKTL) is an aggressive non-Hodgkin lymphoma and the majority of ENKTL cases are diagnosed at the localized stage. Radiotherapy in combination with chemotherapy has been used for localized ENKTL, but the optimal combination treatment modality and the best first-line chemotherapy regimen have not been defined. In this retrospective study, 44 patients with newly diagnosed, stages I/II ENKTL were enrolled and received intensity-modulated radiation therapy (IMRT, 50–56 Gy) followed by GDP (gemcitabine, dexamethasone, and cisplatin) chemotherapy. The median number of chemotherapy cycles per patient was 4 (range, 2–6 cycles). At the end of treatment, the overall response rate was 95% (42/44), including 39 patients (89%) who attained complete response. Two patients developed systemic progression after IMRT. With a median follow-up of 37.5 months, the 3-year overall survival (OS) rate and progression-free survival (PFS) rate were 85% (95% CI, 74 to 96%) and 77% (95% CI, 64 to 91%), respectively. Locoregional and systemic failure rates for this treatment were 9% (4/44) and 14% (6/44), respectively. The most common grades 3 to 4 adverse events included leukopenia (37%), neutropenia (34%), and mucositis (25%). No treatment-related deaths were observed. This study suggested high efficacy and low toxicity of IMRT followed by GDP regimen chemotherapy for newly diagnosed stage I/II ENKTL patients. These results require further investigation in prospective trials.

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Authors and Affiliations

  1. Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China

    Yu Huang, Jianliang Yang, Peng Liu, Shengyu Zhou, Lin Gui, Xiaohui He, Yan Qin, Changgong Zhang, Sheng Yang, Puyuan Xing, Yan Sun & Yuankai Shi

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  1. Yu Huang
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  2. Jianliang Yang
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  3. Peng Liu
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  4. Shengyu Zhou
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  5. Lin Gui
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  6. Xiaohui He
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  7. Yan Qin
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  8. Changgong Zhang
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  9. Sheng Yang
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  10. Puyuan Xing
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  11. Yan Sun
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  12. Yuankai Shi
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Corresponding author

Correspondence to Yuankai Shi.

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All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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The authors declare that they have no conflict of interest.

Funding

This work was supported in part by the National Key Technology Support Program (2014BAI09B12) and CAMS Innovation Fund for Medical Sciences (CIFMS, 2016-I2M-1-001).

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Huang, Y., Yang, J., Liu, P. et al. Intensity-modulated radiation therapy followed by GDP chemotherapy for newly diagnosed stage I/II extranodal natural killer/T cell lymphoma, nasal type. Ann Hematol 96, 1477–1483 (2017). https://doi.org/10.1007/s00277-017-3046-2

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  • DOI: https://doi.org/10.1007/s00277-017-3046-2

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