Concurrent Etoposide,Steroid, High-dose Ara-C and Platinum chemotherapy with radiation therapy in localised extranodal natural killer (NK)/T-cell lymphoma,nasal type |
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| Affiliation: | 1. Gustave Roussy, Department of Hematology, Villejuif F-94805, France;2. Gustave Roussy, Department of Radiation Therapy, Villejuif F-94805, France;3. Gustave Roussy, Department of Pediatric Oncology, Villejuif F-94805, France;4. Gustave Roussy, Department of Pathology, Villejuif F-94805, France;5. Gustave Roussy, Service of Biostatistics and Epidemiology and CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud Univ., Villejuif, France;1. Department of Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People''s Republic of China;2. Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China;3. Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China;4. China National Clinical Research Center for Neurological Diseases, Beijing, China;5. Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China;6. Beijing Key Laboratory of Brain Tumor, Beijing, China;7. China National Clinical Research Center for Neurological Diseases, NCRC-ND, Center of Brain Tumor, Beijing, China;8. Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, Beijing, China;1. Princess Margaret Hospital, Toronto, ON;2. Clinical Trial Service Unit, Oxford University, Oxford, United Kingdom;3. Eastern Cooperative Oncology Group, Boston, MA;1. Division of Radiotherapy, University Hospital “Maggiore della Carità”, Novara, Italy;2. Department of Translational Medicine, University of “Piemonte Orientale”, Novara, Italy;3. Centro Nazionale Adroterapia Oncologica (CNAO), Pavia, Italy;4. Department of Otorhinolaryngology, Humanitas Research Hospital, Rozzano, Milan, Italy;5. Department of Radiotherapy, Istituto Europeo di Oncologia (IEO), Milan, Italy;1. Department of Dermatology, Heidelberg University Hospital, Heidelberg, Germany;2. Department of Dermatology, Mainz University Medical Center, Mainz, Germany;3. Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany;1. Mount Vernon Centre for Cancer Treatment, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK |
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| Abstract: | ![]()
PurposeRadiation combined with chemotherapy has recently been proposed to treat patients with localised extranodal natural killer (NK)/T lymphoma (ENKTL), nasal type. However, the modalities of the chemoradiotherapy combination and drug choices remain a matter of debate. We conducted a concurrent chemoradiotherapy (CCRT) study with the ESHAP (Etoposide, Steroid, High-dose Ara-C and Platinum) regimen.MethodsAn induction phase with two upfront courses of CCRT delivering a 40 Gy dose of radiation concurrently with two cycles of the ESHAP chemotherapy regimen, followed by a consolidation phase with 2–3 cycles of ESHAP chemotherapy alone.ResultsThirteen patients with localised ENKTL nasal type were enrolled between January 2005 and December 2014. The median age was 62 years. Ten and three patients had Ann Arbor stage IE and IIE disease, respectively. They all completed the induction CCRT phase. A median of two consolidation ESHAP cycles were delivered. During consolidation, 8/13 (62%) patients had a reduction in the number of chemotherapy cycles or reduced chemotherapy doses, due to haematologically adverse events. The other five patients (38%) received the full number of ESHAP cycles of chemotherapy scheduled without a dose reduction. All but one patient (92%) experienced grade 3–4 haematological toxicity. The main non-haematological grade 3–4 toxicity was mucositis in 6/13 (46%) patients. All but one patient (92%) achieved a complete remission. Two-year overall survival was 72%.ConclusionsWith optimal management of the specific toxicities induced by this treatment modality, CCRT with the ESHAP regimen yielded high efficacy against localised ENKTL, nasal type. |
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| Keywords: | Extranodal NK/T-cell lymphoma nasal type Concurrent chemoradiotherapy Radiosensitive chemotherapy Multidrug resistance |
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