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Treatment outcome of patients with advanced stage natural killer/T-cell lymphoma: elucidating the effects of asparaginase and postchemotherapeutic radiotherapy

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Abstract

The prognosis of advanced stage natural killer/T-cell lymphoma (NKTCL) remains relatively disappointing, and the optimal treatment strategy for this disease has yet to be discovered. Seventy-three patients with Ann Arbor stage III or IV NKTCL were retrospectively reviewed. The treatment efficacies of asparaginase-containing and asparaginase-absent chemotherapy regimens were compared, and the effects of postchemotherapeutic radiotherapy were explored. The overall response rate (ORR) of the asparaginase-containing regimens was marginally higher than that of the asparaginase-absent regimens (56.5 vs 32.6 %, P = 0.057). However, no significant difference was observed in 2-year overall survival (OS) (38.3 vs 22.7 %, P = 0.418) or 2-year progression-free survival (PFS) (25.4 vs 14.9 %, P = 0.134) between the asparaginase-containing and asparaginase-absent groups. Postchemotherapeutic radiotherapy was associated with a significantly prolonged survival (2-year OS 57.5 vs 14.5 %, P < 0.001; 2-year PFS 46.3 vs 8.4 %, P < 0.001) and was an independent predictor of both OS and PFS. Radiotherapy significantly improved the prognosis among the patients who exhibited complete or partial remission after initial chemotherapy (2-year OS 81.5 vs 40.2 %, P = 0.002; 2-year PFS 65.6 vs 23.4 %, P = 0.008) but failed to provide a significant survival advantage among those who experienced stable or progressive disease after initial chemotherapy. In conclusion, the use of asparaginase did not significantly improve survival for the treatment of patients with stage III/IV NKTCL. Postchemotherapeutic radiotherapy provided additional prognostic benefits to patients who responded well to the initial chemotherapy, which requires further validation in future prospective studies using larger sample sizes.

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Acknowledgments

This work was supported by the National Natural Science Foundation of China (No. 81071950, 81301903).

Conflict of interest

The authors declare that they have no conflict of interest.

Compliance with ethical standards

This is a retrospective study, and all patients provided informed consent for the collection of medical information at their first medical visit. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    Authors and Affiliations

    1. Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, People’s Republic of China

      Xi-Wen Bi, Wen-Qi Jiang, Jia-Jia Huang, Yi Xia, Yu Wang, Peng Sun & Zhi-Ming Li

    2. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong, People’s Republic of China

      Wen-Wen Zhang

    3. State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People’s Republic of China

      Xi-Wen Bi, Wen-Qi Jiang, Wen-Wen Zhang, Jia-Jia Huang, Yi Xia, Yu Wang, Peng Sun & Zhi-Ming Li

    4. Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong, People’s Republic of China

      Xi-Wen Bi, Wen-Qi Jiang, Wen-Wen Zhang, Jia-Jia Huang, Yi Xia, Yu Wang, Peng Sun & Zhi-Ming Li

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    1. Xi-Wen Bi
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    Correspondence to Zhi-Ming Li.

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    Xi-Wen Bi and Wen-Qi Jiang contributed equally to this work.

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    Bi, XW., Jiang, WQ., Zhang, WW. et al. Treatment outcome of patients with advanced stage natural killer/T-cell lymphoma: elucidating the effects of asparaginase and postchemotherapeutic radiotherapy. Ann Hematol 94, 1175–1184 (2015). https://doi.org/10.1007/s00277-015-2336-9

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