Concurrent IMRT and weekly cisplatin followed by GDP chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell lymphoma

• Published in: Blood cancer journal (New York) Vol. 4; no. 12; p. e267
• Main Authors: Ke, Q-H, Zhou, S-Q, Du, W, Liang, G, Lei, Y, Luo, F
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 12.12.2014; Springer Nature B.V; Nature Publishing Group
• Subjects: 692/308/2778; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Biomedical and Life Sciences; Biomedicine; Cancer Research; Chemoradiotherapy; Cisplatin; Deoxycytidine - analogs & derivatives; Dexamethasone; Disease-Free Survival; Female; Hematology; Humans; Lymphoma, T-Cell - diagnosis; Lymphoma, T-Cell - mortality; Lymphoma, T-Cell - therapy; Male; Middle Aged; Neoplasm Staging; Nose Neoplasms - diagnosis; Nose Neoplasms - mortality; Nose Neoplasms - therapy; Oncology; Original; original-article; Survival Rate
• ISSN: 2044-5385; 2044-5385
• DOI: 10.1038/bcj.2014.88

On the basis of the benefits of frontline radiation in early-stage, extranodal natural killer (NK)/T-cell lymphoma (ENKTL), we conducted the trial of concurrent chemoradiotherapy (CCRT) followed by three cycles of gemcitabine, dexamethasone and cisplatin (GDP). Thirty-two patients with newly diagnosed, stage IE to IIE, nasal ENKTL received CCRT (that is, all patients received intensity-modulated radiotherapy 56 Gy and cisplatin 30 mg/m 2 weekly, 3–5 weeks). Three cycles of GDP (gemcitabine 1000 mg/m 2 intravenously (i.v.) on days 1 and 8, dexamethasone 40 mg orally on days 1–4 and cisplatin 75 mg/m 2 i.v. on day 1 (GDP), every 21 days as an outpatient were scheduled after CCRT. All patients completed CCRT, which resulted in 100% response that included 24 complete responses (CRs) and eight partial responses. The CR rate after CCRT was 75.0% (that is, 24 of 32 responses). Twenty-eight of the 32 patients completed the planned three cycles of GDP, whereas four patients did not because they withdrew ( n =1) or because they had an infection ( n =3). The overall response rate and the CR rate were 90.6% (that is, 29 of 32 responses) and 84.4% (that is, 27 of 32 responses), respectively. Only two patient experienced grade 3 toxicity during CCRT (nausea), whereas 13 of the 30 patients experienced grade 4 neutropenia. The estimated 3-year overall survival and progression-free rates were 87.50% and 84.38%, respectively. In conclusion, CCRT followed by GDP chemotherapy can be a feasible and effective treatment strategy for stage IE to IIE nasal ENKTL.