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一项关于“三明治”方案的II期前瞻性研究,即左旋门冬酰胺酶、顺铂、地塞米松和依托泊苷化疗联合同期放疗及顺铂,用于新诊断的I/II期鼻型结外自然杀伤/T细胞淋巴瘤。

A phase II prospective study of the "Sandwich" protocol, L-asparaginase, cisplatin, dexamethasone and etoposide chemotherapy combined with concurrent radiation and cisplatin, in newly diagnosed, I/II stage, nasal type, extranodal natural killer/T-cell lymphoma.

作者信息

Jiang Ming, Zhang Li, Xie Li, Zhang Hong, Jiang Yu, Liu Wei-Ping, Zhang Wen-Yan, Tian Rong, Deng Yao-Tiao, Zhao Sha, Zou Li-Qun

机构信息

Department of Medical Oncology, State Key Laboratory, Cancer Center, West China Hospital of Sichuan University, Chengdu, China.

Department of Oncology, Dujiangyan Medical Center, Dujiangyan, Sichuan, China.

出版信息

Oncotarget. 2017 Jul 25;8(30):50155-50163. doi: 10.18632/oncotarget.16334.

Abstract

Nasal-type, extranodal NK/T cell lymphoma (ENKTCL) is a special type of lymphomas with geographic and racial specificity. Up to now, the standard first-line treatment is still not unified. In our previous report, the "sandwich" protocol produced good results. Continuing to use the "sandwich" mode, a new chemotherapy composed of L-asparaginase, cisplatin, etoposide and dexamethasone (LVDP) plus concurrent chemoradiotherapy (CCRT) was conducted in more patients with newly diagnosed, I/II stage ENKTCL. The results showed that 66 patients were enrolled. Overall response rate was 86.4% including 83.3% complete response and 3.0% partial remission. With the median follow-up of 23.5 months, 3-year overall survival and 3-year progression-free survival were 70.1% and 67.4%, respectively. The survival rate in stage II and extra-cavity stage I was significantly less than that in limited stage I (p < 0.05). Therefore, we thought that the "sandwich" mode was worthy of being generalized and LVDP combined with CCRT was an effective protocol for I/II stage ENKTCL. But this regimen was not suitable for all stage I/II patients and warrants larger sample and layering investigation. This study was a registered clinical trial with number ChiCTR-TNC-12002353.

摘要

鼻型结外NK/T细胞淋巴瘤(ENKTCL)是一种具有地域和种族特异性的特殊类型淋巴瘤。到目前为止,标准的一线治疗仍未统一。在我们之前的报告中,“三明治”方案取得了良好效果。继续采用“三明治”模式,对更多新诊断的Ⅰ/Ⅱ期ENKTCL患者进行了由L-天冬酰胺酶、顺铂、依托泊苷和地塞米松(LVDP)组成的新化疗联合同步放化疗(CCRT)。结果显示,共纳入66例患者。总缓解率为86.4%,其中完全缓解率为83.3%,部分缓解率为3.0%。中位随访23.5个月,3年总生存率和3年无进展生存率分别为70.1%和67.4%。Ⅱ期和腔外Ⅰ期的生存率明显低于局限期Ⅰ期(p<0.05)。因此,我们认为“三明治”模式值得推广,LVDP联合CCRT是Ⅰ/Ⅱ期ENKTCL的有效方案。但该方案并不适用于所有Ⅰ/Ⅱ期患者,需要更大样本和分层研究。本研究是一项注册号为ChiCTR-TNC-12002353的注册临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f714/5564839/9e881072f392/oncotarget-08-50155-g001.jpg

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