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Risk-based, response-adapted therapy for early-stage extranodal nasal-type NK/T-cell lymphoma in the modern chemotherapy era: A China Lymphoma Collaborative Group study.

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机构： [1]National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China [2]Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China [3]Chongqing University Cancer Hospital & Chongqing Cancer Hospital, Chongqing, China [4]Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China [5]Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China [6]The General Hospital of Chinese People's Liberation Army, Beijing,China [7]The Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, China [8]Peking Union Medical College Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China [9]The Fourth Hospital of Hebei Medical University, Shijiazhuang, China [10]Second Affiliated Hospital of Nanchang University, Nanchang, China [11]Beijing Hospital, National Geriatric Medical Center, Beijing, China [12]Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China [13]Shanxi Cancer Hospital and the Affiliated Cancer Hospital of Shanxi Medical University, Taiyuan, Shanxi, China [14]Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China [15]Affiliated Hospital of Guizhou Medical University, Guizhou Cancer Hospital, Guiyang, Guizhou, China [16]Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan, China [17]Xijing Hospital of Fourth Military Medical University, Xi'an, China [18]Tianjin Medical University Cancer Institute & Hospital, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin, China [19]The Fifth Medical Center of PLA General Hospital, Beijing, China [20]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China. [21]Division of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21205-2013, USA

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We aimed to determine the survival benefits of chemotherapy (CT) added to radiotherapy (RT) in different risk groups of patients with early-stage extranodal nasal-type NK/T-cell lymphoma (ENKTCL), and to investigate the risk of postponing RT based on induction CT responses. A total of 1360 patients who received RT with or without new-regimen CT from 20 institutions were retrospectively reviewed. The patients had received RT alone, RT followed by CT (RT + CT), or CT followed by RT (CT + RT). The patients were stratified into different risk groups using the nomogram-revised risk index (NRI). A comparative study was performed using propensity score-matched (PSM) analysis. Adding new-regimen CT to RT (vs RT alone) significantly improved overall survival (OS, 73.2% vs 60.9%, P < .001) and progression-free survival (PFS, 63.5% vs 54.2%, P < .001) for intermediate-risk/high-risk patients, but not for low-risk patients. For intermediate-risk/high-risk patients, RT + CT and CT + RT resulted in non-significantly different OS (77.7% vs 72.4%; P = .290) and PFS (67.1% vs 63.1%; P = .592). For patients with complete response (CR) after induction CT, initiation of RT within or beyond three cycles of CT resulted in similar OS (78.2% vs 81.7%, P = .915) and PFS (68.2% vs 69.9%, P = .519). For patients without CR, early RT resulted in better PFS (63.4% vs 47.6%, P = .019) than late RT. Risk-based, response-adapted therapy involving early RT combined with CT is a viable, effective strategy for intermediate-risk/high-risk early-stage patients with ENKTCL in the modern treatment era. © 2020 Wiley Periodicals LLC.

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出版当年[2020]版：

大类 | 2 区医学

小类 | 2 区血液学

最新[2025]版：

大类 | 1 区

医学

小类 | 2 区血液学

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出版当年[2020]版：

Q1 HEMATOLOGY

最新[2024]版：

Q1 HEMATOLOGY

影响因子： 9.9 最新[2024版] 9.6 最新五年平均 10.047 出版当年[2020版] 7.954 出版当年五年平均 6.973 出版前一年[2019版] 13.268 出版后一年[2021版]

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第一作者机构： [1]National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China

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通讯机构： [1]National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China [*1]State Key Laboratory of Molecular Oncology and Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, P. R. China.

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