Hao Shifeng, Duan Yukai, Hua Renjie, Chang Yuxiao, Li Shuchang, Liu Maosong, Zhao Wanyue, Gao Xiang, Gu Wenjie, Chen Qingjiang, Zhang Xudong
Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
Department of Oncology, The Third Affiliated Hospital of XinXiang Medical University, Xinxiang, Henan Province, China.
Ann Hematol. 2025 Jul;104(7):3723-3731. doi: 10.1007/s00277-025-06497-6. Epub 2025 Jul 5.
This study aimed to investigate the feasibility and safety of low-dose radiotherapy (RT) (< 50 Gy) in patients with stage I/II Extranodal NK/T-cell lymphoma (ENKTCL). Clinical and treatment data from 158 stage I/II ENKTCL patients who received combined chemoradiotherapy at the First Affiliated Hospital of Zhengzhou University from 2020 to 2022 were retrospectively analyzed to compare locoregional control (LC) and survival outcomes between high-dose (≥ 50 Gy) and low-dose (< 50 Gy) RT groups. All patients achieved an objective response (OR) after treatment, with a median follow-up of 51 months. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 90.1% and 81.7% in the high-dose group (n = 130), compared to 84.0% and 68.2% in the low-dose group (n = 28), with no significant statistical differences between the two groups. Notably, no local recurrence was observed in the low-dose group (100% local control rate), and the incidence of grade ≥ 3 RT-related adverse events (AEs) was significantly lower in the low-dose group than in the high-dose group. Preliminary evidence suggests that for newly diagnosed stage I/II ENKTCL patients receiving combined chemoradiotherapy, low-dose radiotherapy may not compromise LC and survival outcomes while reducing the incidence of grade 3-4 adverse events, with 40-45 Gy appearing to be the optimal dose range within the examined parameters.
本研究旨在探讨低剂量放疗（<50 Gy）用于Ⅰ/Ⅱ期结外NK/T细胞淋巴瘤（ENKTCL）患者的可行性和安全性。回顾性分析了2020年至2022年在郑州大学第一附属医院接受放化疗联合治疗的158例Ⅰ/Ⅱ期ENKTCL患者的临床和治疗数据，以比较高剂量（≥50 Gy）和低剂量（<50 Gy）放疗组的局部区域控制（LC）和生存结果。所有患者治疗后均获得客观缓解（OR），中位随访时间为51个月。高剂量组（n = 130）的5年总生存率（OS）和无进展生存率（PFS）分别为90.1%和81.7%，低剂量组（n = 28）分别为84.0%和68.2%，两组间无显著统计学差异。值得注意的是，低剂量组未观察到局部复发（局部控制率为100%），且低剂量组≥3级放疗相关不良事件（AE）的发生率显著低于高剂量组。初步证据表明，对于新诊断的接受放化疗联合治疗的Ⅰ/Ⅱ期ENKTCL患者，低剂量放疗可能不会影响LC和生存结果，同时可降低3 - 4级不良事件的发生率，在所研究参数范围内，40 - 45 Gy似乎是最佳剂量范围。
