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Feasibility of low-dose radiotherapy for patients with stage I/II extranodal NK-/ T -cell lymphoma, nasal type achieving complete response after l-asparaginase-containing chemotherapy.
- Source :
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Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2022 Nov 03; Vol. 38, pp. 155-160. Date of Electronic Publication: 2022 Nov 03 (Print Publication: 2023). - Publication Year :
- 2022
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Abstract
- Purpose: To assess treatment outcomes in patients with stage I/II extranodal NK-/ T -cell lymphoma, nasal type (ENKTCL-NT) and the feasibility of low-dose radiotherapy (RT) for achieving complete response (CR, defined as showing no residual hypermetabolic uptake on positron emission tomography [PET] or no residual lesions on computed tomography [CT]) after l-asparaginase-containing chemotherapy (l-ASP).<br />Materials and Methods: Between 1992 and 2018, 76 patients with early-stage ENKTCL-NT who achieved CR or partial response (PR) after induction chemotherapy received adjuvant RT. RT doses (using biologically equivalent doses in 2 Gy fractions [EQD2]) and rates of local recurrence-free survival (LRFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and cancer-specific survival (CSS) were determined.<br />Results: Median follow-up was 5.1 years (range, 0.5-20.8). The median RT dose was 45 Gy (range, 20-54). The 5-year LRFS, LRRFS, DMFS, PFS, and CSS rates were 82.7 %, 78.2 %, 81.1 %, 68.7 %, and 84.4 %, respectively. CR after induction chemotherapy was notably linked to better survival outcomes across each endpoint. Survival outcomes were not affected either by the administration of l-ASP or EQD2 < 40 Gy in patients displaying CR after l-ASP. Adverse events (AEs) ≥ Grade 2 were significantly reduced with EQD2 < 40 Gy, compared with EQD2 ≥ 40 Gy.<br />Conclusion: Achieving CR after chemotherapy was the most predictive factor of survival outcomes in early-stage ENKTCL-NT. Decreasing RT doses in patients with CR after l-ASP appeared to minimize the occurrence of AE without compromising LRR risk; however, longer follow-ups and cautious application are warranted.<br />Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (© 2022 The Author(s).)
Details
- Language :
- English
- ISSN :
- 2405-6308
- Volume :
- 38
- Database :
- MEDLINE
- Journal :
- Clinical and translational radiation oncology
- Publication Type :
- Academic Journal
- Accession number :
- 36466747
- Full Text :
- https://doi.org/10.1016/j.ctro.2022.10.014