早期鼻型结节外 NK/T 细胞淋巴瘤：选择性结节照射的作用？

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2024-10-09 DOI:10.1016/j.adro.2024.101650

Penny Fang MD, MBA , Sonal S. Noticewala MD , Susan Y. Wu MD , Jillian R. Gunther MD, PhD , Ethan B. Ludmir MD , L. Jeffrey Medeiros MD , Paolo Strati MD , Ranjit Nair MD , Chijioke Nze MD , Loretta J. Nastoupil MD , Sairah Ahmed MD , Luis Malpica Castillo MD , Luis Fayad MD , Jason Westin MD , Sattva Neelapu MD , Christopher Flowers MD , Auris Huen MD , Swaminathan P. Iyer MD , Bouthaina Dabaja MD , Chelsea C. Pinnix MD, PhD

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引用次数: 0

摘要

目的结节外NK/T细胞淋巴瘤（ENKTCL）在西半球非常罕见，通常采用联合模式疗法（CMT）治疗。方法和材料我们回顾性分析了1994年至2015年期间在美国一家大型学术癌症中心接受Ann Arbor I/II期ENKTCL治疗的35例患者。18名患者（51%）疾病复发，其中5名患者为区域性结节复发，2名患者为区域性和远处复发。所有5例区域性结节复发均发生在未接受选择性结节照射（ENI）治疗的患者中。ENI与无进展生存期的改善有关（危险比[HR]，0.21；95% CI，0.09-0.52；P = .018），但与OS无明显关系（HR，0.33；95% CI，0.11-0.94；P = .11）。结论在这个西半球队列中，接受CMT治疗的早期ENKTCL患者中，ENI可能具有潜在的临床益处，尤其是在接受非含天冬酰胺酶的CMT治疗的患者中，如单独接受放疗的患者、同时接受强化程度较低的化疗的患者或无法耐受强化化疗的患者。

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Early-Stage Extranodal NK/T-Cell Lymphoma, Nasal Type: A Role for Elective Nodal Irradiation?

Purpose

Extranodal NK/T-cell lymphoma (ENKTCL) is rare in the Western Hemisphere and is commonly treated with combined modality therapy (CMT).

Methods and Materials

We retrospectively reviewed 35 patients treated with Ann Arbor stage I/II ENKTCL between 1994 and 2015 at a large academic cancer center in the United States.

Results

With 11.6 years median follow-up, median overall survival and progression-free survival were 13.5 and 7.5 years, respectively. Eighteen (51%) patients experienced disease relapse, with 5 regional nodal relapses, of which 2 experienced combined regional and distant relapses. All 5 regional nodal relapses occurred exclusively among patients not treated with elective nodal irradiation (ENI). ENI was associated with improved progression-free survival (hazard ratio [HR], 0.21; 95% CI, 0.09-0.52; P = .018) without significant association with OS (HR, 0.33; 95% CI, 0.11-0.94; P = .11). There was a trend toward improved local control with radiation dose to the primary tumor ≥50 Gy (HR, 0.29; 95% CI, 0.08-1.08; P = .098).

Conclusions

In this Western Hemisphere cohort of early-stage ENKTCL patients treated with CMT, ENI may have a potential clinical benefit, particularly in patients who are treated with non–asparaginase-containing CMT, such as in patients treated with radiation alone, patients treated with less intensive chemotherapy concurrently, or patients who are unable to tolerate intensive chemotherapy.

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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.