State Key Laboratory of Molecular Oncology and Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China.
Chongqing University Cancer Hospital & Chongqing Cancer Hospital, Chongqing, China.
Leukemia. 2021 Jun;35(6):1671-1682. doi: 10.1038/s41375-020-01042-y. Epub 2020 Sep 17.
Limited evidence supports the use of early endpoints to evaluate the success of initial treatment of extranodal NK/T-cell lymphoma (ENKTCL) in the modern era. We aim to analyze progression-free survival at 24 months (PFS24) and subsequent overall survival (OS) in a large-scale multicenter cohort of patients. 1790 patients were included from the China Lymphoma Collaborative Group (CLCG) database. Subsequent OS was defined from the time of PFS24 or progression within 24 months to death. OS was compared with age- and sex-matched general Chinese population using expected survival and standardized mortality ratio (SMR). Patients who did not achieve PFS24 had a median OS of 5.3 months after progression, with 5-year OS rate of 19.2% and the SMR of 71.4 (95% CI, 62.9-81.1). In contrast, 74% patients achieved PFS24, and the SMR after achieving PFS24 was 1.77 (95% CI, 1.34-2.34). The observed OS rate after PFS24 versus expected OS rate at 5 years was 92.2% versus 94.3%. Similarly, superior outcomes following PFS24 were observed in early-stage patients (5-year OS rate, 92.9%). Patients achieving PFS24 had excellent outcome, whereas patients exhibiting earlier progression had a poor survival. These marked differences suggest that PFS24 may be used for study design and risk stratification in ENKTCL.
早期终点在评估现代时代结外 NK/T 细胞淋巴瘤（ENKTCL）初始治疗成功方面的证据有限。我们旨在分析大规模多中心患者队列的 24 个月无进展生存期（PFS24）和随后的总生存期（OS）。从中国淋巴瘤协作组（CLCG）数据库中纳入了 1790 例患者。随后的 OS 定义为从 PFS24 时间或 24 个月内进展至死亡的时间。OS 通过预期生存和标准化死亡率比（SMR）与年龄和性别匹配的一般中国人群进行比较。未达到 PFS24 的患者在进展后中位 OS 为 5.3 个月，5 年 OS 率为 19.2%，SMR 为 71.4（95%CI，62.9-81.1）。相比之下，74%的患者达到了 PFS24，达到 PFS24 后的 SMR 为 1.77（95%CI，1.34-2.34）。达到 PFS24 后的观察 OS 率与 5 年的预期 OS 率分别为 92.2%和 94.3%。同样，在早期患者中观察到 PFS24 后更好的结果（5 年 OS 率为 92.9%）。达到 PFS24 的患者结局良好，而较早进展的患者生存较差。这些显著差异表明，PFS24 可能用于 ENKTCL 的研究设计和风险分层。
