化疗联合放疗对早期结节外天然杀伤/T细胞淋巴瘤患者的治疗效果和预后因素

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2024-09-28 DOI:10.1016/j.adro.2024.101647

Shu-Bei Wang MD , Jia-Yi Chen MD , Wei-Li Zhao MD , Cheng Xu MD , Wei-Guo Cao MD , Yi-Min Han MD , Shu Cheng MD , Peng-Peng Xu MD , Hui-Juan Zhong MD , Gang Cai MD

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引用次数: 0

摘要

目的本研究旨在评估放疗联合化疗治疗早期结节外天然杀伤细胞/T细胞淋巴瘤患者的治疗效果、毒性和潜在预后因素。方法和材料回顾性分析了2003年7月至2019年1月期间接受放疗联合化疗治疗的118例I/II期结节外天然杀伤细胞/T细胞淋巴瘤患者。中位剂量为50 Gy（范围为45-61.2 Gy）。采用 Kaplan-Meier 法计算无进展生存期和总生存期。根据预后指数对患者进行评分。结果总反应率和完全反应率分别为 93.2% 和 82.2%。中位随访时间为43个月，5年总生存率和无进展生存率分别为73.9%和68.4%。20名患者（16.9%）出现了3级或以上的不良反应。原发疾病位于Waldeyer环的患者生存率较低（P = .015）。与蒽环类药物治疗方案相比，非蒽环类药物治疗方案显著提高了患者的5年总生存期（76.6% vs 54.8%，P = .027）和无进展生存期（72.4% vs 53.1%，P = .013）。治疗后，完全应答患者的 5 年总生存率为 78.6%，而非完全应答患者为 44.9%（P = .003）。根据提名图-修订风险指数模型，低风险和中低风险患者的完全应答率为100%。结论早期结节外自然杀伤/T细胞淋巴瘤患者在接受放疗和非蒽环类化疗方案后反应率高，生存率好。获得完全应答的患者比未获得完全应答的患者生存率更高。结节外自然杀伤/T细胞淋巴瘤特异性预后模型可能需要进一步优化。

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Treatment Outcomes and Prognostic Factors of Chemotherapy Combined With Radiation Therapy for Patients With Early-Stage Extranodal Natural Killer/T-Cell Lymphoma

Purpose

This study aimed to assess the treatment outcomes, toxicity, and potential prognostic factors in patients with early-stage extranodal natural killer/T-cell lymphoma treated with radiation therapy combined with chemotherapy.

Methods and Materials

One hundred eighteen patients with stage I/II extranodal natural killer/T-cell lymphoma who were treated with radiation therapy combined with chemotherapy were retrospectively analyzed between July 2003 and January 2019. The median dose was 50 Gy (Range, 45-61.2 Gy). The Kaplan-Meier method was used to calculate progression-free survival and overall survival. The patients were scored according to their prognostic indices.

Results

The overall and complete response rates were 93.2% and 82.2%, respectively. At a median follow-up of 43 months, the 5-year overall survival and progression-free survival rates were 73.9% and 68.4%, respectively. Adverse events of grade 3 or higher were observed in 20 patients (16.9%). Patients with primary disease in the Waldeyer's ring had poorer survival (P = .015). Compared with anthracycline-based regimens, non–anthracycline-based regimens significantly improved the 5-year overall survival (76.6% vs 54.8%, P = .027) and progression-free survival (72.4% vs 53.1%, P = .013). After treatment, the 5-year overall survival rate was 78.6% in complete response patients versus 44.9% in noncomplete response patients (P = .003). For patients with low- and intermediate-low-risk according to the nomogram-revised risk index model, the complete response rate was 100%. When primary lesion data were added to the nomogram-revised risk index as the basis for another prognostic index (modified nomogram-revised risk index), the low-risk (0 to 2 risk factors) and high-risk (3 or more risk factors) categories were noted (84.2% vs 62.2%, P = .036).

Conclusions

Patients with early-stage extranodal natural killer/T-cell lymphoma had high response rates and favorable survival rates with radiation therapy and non–anthracycline-based chemotherapy regimens. Patients who achieved complete response had better survival than those who did not. The extranodal natural killer/T-cell lymphoma-specific prognostic models may require further optimization.

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.