Study of L-Asparaginase, Vincristine, and Dexamethasone Combined With Intensity-modulated Radiation Therapy in Early-Stage Nasal NK/T-Cell Lymphoma
| Autor: | Mengxiang Chen, Yunfei Hu, Jing Zhang, Feng Gou, Yunhong Huang, Xiaomei Liu, Yang Song |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Vincristine Adolescent medicine.medical_treatment Nose Neoplasms Lymphoma T-Cell Gastroenterology Dexamethasone 03 medical and health sciences Hypoproteinemia Young Adult 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols Medicine Asparaginase Humans 030212 general & internal medicine Survival analysis Aged Retrospective Studies Chemotherapy business.industry Middle Aged medicine.disease Combined Modality Therapy Radiation therapy Killer Cells Natural Regimen Treatment Outcome Oncology 030220 oncology & carcinogenesis Female Radiotherapy Intensity-Modulated business Progressive disease medicine.drug |
| Zdroj: | American journal of clinical oncology. 43(4) |
| ISSN: | 1537-453X |
| Popis: | OBJECTIVES Natural killer/T-cell lymphoma (NKTCL) is aggressive, and carries a poor prognosis worldwide. This retrospective study aimed to evaluate the clinical efficacy and safety of the LVD regimen (L-asparaginase, vincristine, and dexamethasone) combined with intensity-modulated radiation therapy (IMRT) for the treatment of early-stage nasal NKTCL in a Chinese population. METHODS The clinical data were collected from patients treated between March 2010 and January 2017. Patients received LVD chemotherapy combined with IMRT, and were followed for 30 to 90 months. All received radiotherapy at the end of the first/second cycle of chemotherapy. The survival curves were generated by the Kaplan-Meier method. RESULTS Among 94 patients who received 2 to 6 cycles (mean, 4 cycles) of treatments, 56 and 25 achieved complete and partial remission, respectively; 2 and 11 experienced stable disease and progressive disease. The overall objective response was 86.2%. Patients with elevated lactate dehydrogenase and skin invasion had a lower objective response rate. The progression-free survival rates at 1, 3, and 5 years were 90.3%, 73.5%, and 71.3%; the corresponding overall survival rates were 91.4%, 74.3%, and 74.3%. The main adverse events were myelosuppression (63.8% grades I to II, 12.8% grade III), gastrointestinal symptoms (63.8% grades I to II), hepatic lesion (55.3% grades I to II), hypoproteinemia (46.8% grades I to II), skin allergies (77.7% grades I to II, 3.2% grade III), and oral mucosal lesions (44.7% grades I to II, 33% grade III). No severe pancreatitis, anaphylaxis, or toxicity-related death was observed. CONCLUSION In patients with early-stage nasal NKTCL, our LVD-IMRT regimen produced excellent, durable therapeutic benefit in most patients, with acceptable toxicity and no acute mortality. |
| Databáze: | OpenAIRE |
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