Background In stage I/II natural killer (NK)/T-cell lymphoma, concurrent chemoradiotherapy (CCRT) had previously been shown to result in superior outcome compared with anthracycline-containing regimens, which have since been considered ineffective. The role of CCRT in comparison with approaches employing nonanthracycline-containing chemotherapy (CT) and sequential radiotherapy (RT) in such patients remains to be defined. Patients and methods Three hundred and three untreated patients (207 men, 96 women; median age: 51, 18-86 years) with stage I/II NK/T-cell lymphoma who had received nonanthracycline-containing regimens were collected from an international consortium and retrospectively analyzed. Treatment included single modality (CT and RT), sequential modalities (CT + RT; RT + CT) and concurrent modalities (CCRT; CCRT + CT). The impact of clinicopathologic parameters and types of treatment on complete response (CR) rate, progression-free-survival (PFS) and overall-survival (OS) was evaluated. Results For CR, stage (P = 0.027), prognostic index for NK/T-cell lymphoma (PINK) (P = 0.026) and types of initial treatment (P = 0.011) were significant prognostic factors on multivariate analysis. On Cox regression analysis, ECOG performance score (P = 0.021) and PINK-EBV DNA (PINK-E) (P = 0.002) significantly impacted on PFS; whereas ECOG performance score (P = 0.008) and stage (P < 0.001) significantly impacted on OS. For comparing CCRT ± CT and sequential CT + RT, CCRT ± CT patients (n = 190) were similar to sequential CT + RT patients (n = 54) in all evaluated clinicopathologic parameters except two significantly superior features (higher proportion of undetectable circulating EBV DNA on diagnosis and lower PINK-E scores). Despite more favorable pre-treatment characteristics, CCRT ± CT patients had CR rate, PFS and OS comparable with sequential CT + RT patients on multivariate and Cox regression analyses. Conclusions In stage I/II NK/T-cell lymphomas, when effective chemotherapeutic regimens were used, CCRT and sequential CT + RT gave similar outcome.

中文翻译：

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I / II期NK / T细胞淋巴瘤的序贯化学疗法/放疗与同期放化疗相当。

背景技术在I / II期自然杀伤（NK）/ T细胞淋巴瘤中，同时放化疗（CCRT）已被证明比含蒽环类药物的治疗方案具有更好的结局，后者被认为是无效的。与在此类患者中采用含非蒽环类化学疗法（CT）和序贯放疗（RT）的方法相比，CCRT的作用尚待确定。患者和方法从一个国际财团收集了303例未经治疗的I / II期NK / T细胞淋巴瘤患者（男207例，女性96例；中位年龄：51岁，18-86岁）。并进行回顾性分析。治疗包括单一方式（CT和RT），顺序方式（CT + RT； RT + CT）和同时方式（CCRT； CCRT + CT）。评估了临床病理参数和治疗类型对完全缓解率（CR），无进展生存期（PFS）和总体生存期（OS）的影响。结果对于多因素分析，CR的分期（P = 0.027），NK / T细胞淋巴瘤（PINK）的预后指数（P = 0.026）和初始治疗的类型（P = 0.011）是重要的预后因素。在Cox回归分析中，ECOG成绩得分（P = 0.021）和PINK-EBV DNA（PINK-E）（P = 0.002）对PFS有显着影响。而ECOG成绩得分（P = 0.008）和阶段（P <0.001）对OS有显着影响。为了比较CCRT±CT和顺序CT + RT，CCRT±CT患者（n = 190）在所有评估的临床病理学参数上均与连续CT + RT患者（n = 54）相似，除了两个明显的优越特征（诊断中无法检测到的循环EBV DNA比例更高和PINK-E评分较低）。尽管有更有利的治疗前特征，但在多因素和Cox回归分析中，CCRT±CT患者的CR率，PFS和OS与连续CT + RT患者相当。结论在I / II期NK / T细胞淋巴瘤中，当采用有效的化疗方案时，CCRT和顺序CT + RT的结果相似。