Department of Medical Oncology of Cancer Center, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, China.
Ann Hematol. 2022 Jul;101(7):1557-1565. doi: 10.1007/s00277-022-04828-5. Epub 2022 May 18.
Chemotherapy combined with radiotherapy could reduce the risk of recurrence in early-stage extranodal NK/T lymphoma (ENKTL). However, the optimal combined chemotherapy regimen is still unknown. Our previous study reported that LVDP (L-asparaginase, etoposide, dexamethasone, and cisplatin) combined with radiotherapy was a potentially effective and safe treatment regimen for early-stage ENKTL. This study further validated the efficacy and safety of LVDP chemotherapy combined with radiation for early-stage ENKTL with more patients and longer follow-up. We retrospectively studied 112 patients with early-stage ENKTL from September 2010 to September 2019. All patients received the LVDP regimen, and 101 of them received radiotherapy. The patients' characteristics, treatment responses, survival outcomes, prognostic factors, and toxicities were analyzed. The median follow-up was 60 months (range, 4 to 117). All patients received median 4 cycles of the LVDP chemotherapy. At the end of therapy, the objective response rate and complete response rate were 88.3% and 77.6%, respectively. The 3- and 5-year OS were 79.6% and 73.2%, and the 3- and 5-year PFS were 75.4% and 71.6%, respectively. Among them, the LVDP regimen combined with radiotherapy yielded more favorable treatment outcomes (the 3-year OS and PFS were 83.1% and 80.8%). The most common severe hematologic toxicity was leukopenia (25% grade 3/4), and the most common severe non-hematologic toxicity was increased transaminase (4.5% grade 3/4). No pancreatitis or treatment-related death occurred. The LVDP regimen combined with radiotherapy had a good therapeutic response and long-term survival with tolerable toxicity for patients with early-stage ENKTL.
化疗联合放疗可降低早期结外 NK/T 细胞淋巴瘤（ENKTL）的复发风险。然而，最佳的联合化疗方案仍不清楚。我们之前的研究报道，LVDP（门冬酰胺酶、依托泊苷、地塞米松和顺铂）联合放疗是早期 ENKTL 潜在有效且安全的治疗方案。本研究进一步验证了 LVDP 化疗联合放疗治疗早期 ENKTL 的疗效和安全性，纳入了更多的患者和更长的随访时间。我们回顾性研究了 2010 年 9 月至 2019 年 9 月期间 112 例早期 ENKTL 患者。所有患者均接受 LVDP 方案治疗，其中 101 例患者接受放疗。分析了患者的特征、治疗反应、生存结局、预后因素和毒性反应。中位随访时间为 60 个月（范围为 4 至 117 个月）。所有患者均接受了中位 4 个周期的 LVDP 化疗。治疗结束时，客观缓解率和完全缓解率分别为 88.3%和 77.6%。3 年和 5 年 OS 率分别为 79.6%和 73.2%，3 年和 5 年 PFS 率分别为 75.4%和 71.6%。其中，LVDP 方案联合放疗的治疗结局更优（3 年 OS 和 PFS 率分别为 83.1%和 80.8%）。最常见的严重血液学毒性为白细胞减少（25%为 3/4 级），最常见的严重非血液学毒性为转氨酶升高（4.5%为 3/4 级）。无胰腺炎或治疗相关死亡发生。LVDP 方案联合放疗治疗早期 ENKTL 具有良好的治疗反应和长期生存，毒性可耐受。
