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Published in: Medical Oncology 3/2010

01-09-2010 | Original Paper

Treatment outcome of radiotherapy alone versus radiochemotherapy in early stage nasal natural killer/T-cell lymphoma

Authors: Hui-Hui Ma, Li-Ting Qian, Hai-Feng Pan, Lin Yang, Hong-Yan Zhang, Zhi-Hua Wang, Jun Ma, Yu-Fei Zhao, Jin Gao, Ai-Dong Wu

Published in: Medical Oncology | Issue 3/2010

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Abstract

This study aims to investigate the prognostic factors and long-term treatment outcome in patients with early stage nasal natural killer (NK)/T-cell lymphoma. Sixty-four patients were recruited in this study, whose clinical and laboratory data were collected from hospital records. Early stage (stage IE: 51, stage IIE: 13) nasal NK/T-cell lymphoma (NNTCL) was established according to Ann Arbor staging classification. Among these patients, 23 received radiotherapy (RT) alone, the remaining 41 cases were treated with radiochemotherapy (RCT) comprised of 1–6 cycles of anthracycline-based chemotherapeutic regimens. Results show that the median overall survival (OS) time was 41 months. The 5-year OS and progression-free survival rates were 59.2 and 52.3%, respectively. The 5-year OS rate for patients who received RT alone was 57.9%, whereas that for patients who received RCT was 61.5% (P = 0.47). There is no significant difference between two treatment modalities. Multivariate analysis showed that Eastern Cooperative Oncology Group performance status (PS) score ≥ 2, local tumor invasion out of nasal cavity, and lower complete remission (CR) rates in the initial treatment were significant unfavorable independent prognostic factors. Taken together, our study suggests that RCT did not improve the survival rate of patients with early stage NNTCL. PS score before treatment, local tumor invasion out of nasal cavity, and CR rate of the primary treatment may be independent prognostic factors among the subtype lymphoma entity.
Literature
1.
go back to reference Cuadra-Garcia I, et al. Sinonasal lymphoma: a clinicopathologic analysis of 58 cases from the Massachusetts General Hospital. Am J Surg Pathol. 1999;23:1356–69.CrossRefPubMed Cuadra-Garcia I, et al. Sinonasal lymphoma: a clinicopathologic analysis of 58 cases from the Massachusetts General Hospital. Am J Surg Pathol. 1999;23:1356–69.CrossRefPubMed
2.
go back to reference Savage KJ, Chhanabhai M, Gascoyne RD, Connors JM. Characterization of peripheral T-cell lymphomas in a single North American institution by the WHO classification. Ann Oncol. 2004;15:1467–75.CrossRefPubMed Savage KJ, Chhanabhai M, Gascoyne RD, Connors JM. Characterization of peripheral T-cell lymphomas in a single North American institution by the WHO classification. Ann Oncol. 2004;15:1467–75.CrossRefPubMed
3.
go back to reference Grau C, et al. Sino-nasal cancer in Denmark 1982–1991: a nationwide survey. Acta Oncol. 2001;40:19–23.CrossRefPubMed Grau C, et al. Sino-nasal cancer in Denmark 1982–1991: a nationwide survey. Acta Oncol. 2001;40:19–23.CrossRefPubMed
4.
go back to reference Aviles A, Rodriguez L, Guzman R, Talavera A, Garcia EL, Diaz-Maqueo JC. Angiocentric T-cell lymphoma of the nose, paranasal sinuses and hard palate. Hematol Oncol. 1992;10:141–7.CrossRefPubMed Aviles A, Rodriguez L, Guzman R, Talavera A, Garcia EL, Diaz-Maqueo JC. Angiocentric T-cell lymphoma of the nose, paranasal sinuses and hard palate. Hematol Oncol. 1992;10:141–7.CrossRefPubMed
5.
go back to reference Cheung MM, et al. Primary non-Hodgkin’s lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients. J Clin Oncol. 1998;16:70–7.PubMed Cheung MM, et al. Primary non-Hodgkin’s lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients. J Clin Oncol. 1998;16:70–7.PubMed
6.
go back to reference Jaffe ES, et al. Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphomas: definitions, differential diagnosis and epidemiology. Am J Surg Pathol. 1996;20:103–11.CrossRefPubMed Jaffe ES, et al. Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphomas: definitions, differential diagnosis and epidemiology. Am J Surg Pathol. 1996;20:103–11.CrossRefPubMed
7.
go back to reference Kim GE, et al. Angiocentric lymphoma of the head and neck: patterns of systemic failure after radiation treatment. J Clin Oncol. 2000;18:54–63.PubMed Kim GE, et al. Angiocentric lymphoma of the head and neck: patterns of systemic failure after radiation treatment. J Clin Oncol. 2000;18:54–63.PubMed
8.
go back to reference Ko YH, et al. REAL classification of malignant lymphomas in the Republic of Korea. Cancer. 1998;83:806–12.CrossRefPubMed Ko YH, et al. REAL classification of malignant lymphomas in the Republic of Korea. Cancer. 1998;83:806–12.CrossRefPubMed
9.
go back to reference Liang R, et al. Treatment outcome and prognostic factors for primary nasal lymphoma. J Clin Oncol. 1995;13:666–70.PubMed Liang R, et al. Treatment outcome and prognostic factors for primary nasal lymphoma. J Clin Oncol. 1995;13:666–70.PubMed
10.
go back to reference Quintanilla-Martinez L, et al. Histological and immunophenotypic profile of nasal NK/T-cell lymphomas from Peru: high prevalence of p53 overexpression. Hum Pathol. 1999;30:849–55.CrossRefPubMed Quintanilla-Martinez L, et al. Histological and immunophenotypic profile of nasal NK/T-cell lymphomas from Peru: high prevalence of p53 overexpression. Hum Pathol. 1999;30:849–55.CrossRefPubMed
11.
go back to reference Gaal K, Sun NC, Hernandez AM, Arber DA. Sinonasal NK/T-cell lymphomas in the United States. Am J Surg Pathol. 2000;24:1511–7.CrossRefPubMed Gaal K, Sun NC, Hernandez AM, Arber DA. Sinonasal NK/T-cell lymphomas in the United States. Am J Surg Pathol. 2000;24:1511–7.CrossRefPubMed
12.
go back to reference Harris NL, et al. A revised European–American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994;84:1361–92.PubMed Harris NL, et al. A revised European–American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994;84:1361–92.PubMed
13.
go back to reference Cheung MM, Chan JK, Lau WH, Ngan RK, Foo WW. Early stage nasal NK/T-cell lymphoma: clinical outcome, prognostic factors, and the effect of treatment modality. Int J Radiat Oncol Biol Phys. 2002;54:182–90.PubMed Cheung MM, Chan JK, Lau WH, Ngan RK, Foo WW. Early stage nasal NK/T-cell lymphoma: clinical outcome, prognostic factors, and the effect of treatment modality. Int J Radiat Oncol Biol Phys. 2002;54:182–90.PubMed
14.
go back to reference Harabuchi Y, et al. Nasal T-cell lymphoma causally associated with Epstein Barr virus: clinicopathologic, phenotypic, and genotypic studies. Cancer. 1996;77:2137–49.CrossRefPubMed Harabuchi Y, et al. Nasal T-cell lymphoma causally associated with Epstein Barr virus: clinicopathologic, phenotypic, and genotypic studies. Cancer. 1996;77:2137–49.CrossRefPubMed
15.
go back to reference Kuo TT, Shih LY, Tsang NM. Nasal NK/T cell lymphoma in Taiwan: a clinicopathologic study of 22 cases, with analysis of histologic subtypes, Epstein-Barr virus LMP-1 gene association, and treatment modalities. Int J Surg Pathol. 2004;12:375–87.CrossRefPubMed Kuo TT, Shih LY, Tsang NM. Nasal NK/T cell lymphoma in Taiwan: a clinicopathologic study of 22 cases, with analysis of histologic subtypes, Epstein-Barr virus LMP-1 gene association, and treatment modalities. Int J Surg Pathol. 2004;12:375–87.CrossRefPubMed
16.
go back to reference Quintanilla-Martinez L, et al. p53 Mutations in nasal natural killer/T-cell lymphoma from Mexico: association with large cell morphology and advanced disease. Am J Pathol. 2001;159:2095–105.PubMed Quintanilla-Martinez L, et al. p53 Mutations in nasal natural killer/T-cell lymphoma from Mexico: association with large cell morphology and advanced disease. Am J Pathol. 2001;159:2095–105.PubMed
17.
go back to reference Hongyo T, et al. p53, K-ras, c-kit and beta-catenin gene mutations in sinonasal NK/T-cell lymphoma in Korea and Japan. Oncol Rep. 2005;13:265–71.PubMed Hongyo T, et al. p53, K-ras, c-kit and beta-catenin gene mutations in sinonasal NK/T-cell lymphoma in Korea and Japan. Oncol Rep. 2005;13:265–71.PubMed
18.
go back to reference Harris NL, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the clinical advisory committee meeting—Airlie House, Virginia, November 1997. J Clin Oncol. 1999;17:3835–49.PubMed Harris NL, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the clinical advisory committee meeting—Airlie House, Virginia, November 1997. J Clin Oncol. 1999;17:3835–49.PubMed
19.
go back to reference Kim GE, et al. Combined chemotherapy and radiation versus radiation alone in the management of localized angiocentric lymphoma of the head and neck. Radiother Oncol. 2001;61:261–9.CrossRefPubMed Kim GE, et al. Combined chemotherapy and radiation versus radiation alone in the management of localized angiocentric lymphoma of the head and neck. Radiother Oncol. 2001;61:261–9.CrossRefPubMed
20.
go back to reference Kim WS, et al. CHOP followed by involved field radiation: is it optimal for localized nasal natural killer/T-cell lymphoma? Ann Oncol. 2001;12:349–52.CrossRefPubMed Kim WS, et al. CHOP followed by involved field radiation: is it optimal for localized nasal natural killer/T-cell lymphoma? Ann Oncol. 2001;12:349–52.CrossRefPubMed
21.
go back to reference Ribrag V, et al. Early locoregional high-dose radiotherapy is associated with long-term disease control in localized primary angiocentric lymphoma of the nose and nasopharynx. Leukemia. 2001;15:1123–6.CrossRefPubMed Ribrag V, et al. Early locoregional high-dose radiotherapy is associated with long-term disease control in localized primary angiocentric lymphoma of the nose and nasopharynx. Leukemia. 2001;15:1123–6.CrossRefPubMed
22.
go back to reference Avilés A, Díaz NR, Neri N, Cleto S, Talavera A. Angiocentric nasal T/natural killer cell lymphoma: a single centre study of prognostic factors in 108 patients. Clin Lab Haematol. 2000;22:215–20.CrossRefPubMed Avilés A, Díaz NR, Neri N, Cleto S, Talavera A. Angiocentric nasal T/natural killer cell lymphoma: a single centre study of prognostic factors in 108 patients. Clin Lab Haematol. 2000;22:215–20.CrossRefPubMed
23.
go back to reference Cheson BD, et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol. 1999;17:1244. Cheson BD, et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol. 1999;17:1244.
24.
go back to reference Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–81.CrossRef Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–81.CrossRef
25.
go back to reference Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep. 1966;50:163–70.PubMed Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep. 1966;50:163–70.PubMed
26.
go back to reference Cox DR. Regression models and life-tables (with discussion). J R Stat Soc B. 1972;34:187–220. Cox DR. Regression models and life-tables (with discussion). J R Stat Soc B. 1972;34:187–220.
27.
go back to reference The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med. 1993;329:987–94. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med. 1993;329:987–94.
28.
go back to reference Chen HH, et al. Experience of radiotherapy in lethal midline granuloma with special emphasis on centrofacial T-cell lymphoma: a retrospective analysis covering a 34-year period. Radiother Oncol. 1996;38:1–6.CrossRefPubMed Chen HH, et al. Experience of radiotherapy in lethal midline granuloma with special emphasis on centrofacial T-cell lymphoma: a retrospective analysis covering a 34-year period. Radiother Oncol. 1996;38:1–6.CrossRefPubMed
29.
go back to reference Sakata K, et al. Treatment of lethal midline granuloma type nasal T-cell lymphoma. Acta Oncol. 1997;36:307–11.CrossRefPubMed Sakata K, et al. Treatment of lethal midline granuloma type nasal T-cell lymphoma. Acta Oncol. 1997;36:307–11.CrossRefPubMed
30.
go back to reference Itami J, et al. Non-Hodgkin’s lymphoma confined to the nasal cavity: its relationship to the polymorphic reticulosis and results of radiation therapy. Int J Radiat Oncol Biol Phys. 1991;20:797–802.PubMed Itami J, et al. Non-Hodgkin’s lymphoma confined to the nasal cavity: its relationship to the polymorphic reticulosis and results of radiation therapy. Int J Radiat Oncol Biol Phys. 1991;20:797–802.PubMed
31.
go back to reference Smalley SR, et al. Polymorphic reticulosis limited to the upper aerodigestive tract—natural history and radiotherapeutic considerations. Int J Radiat Oncol Biol Phys. 1988;15:599–605.PubMed Smalley SR, et al. Polymorphic reticulosis limited to the upper aerodigestive tract—natural history and radiotherapeutic considerations. Int J Radiat Oncol Biol Phys. 1988;15:599–605.PubMed
32.
go back to reference Lee J, et al. Nasal-type NK/T cell lymphoma: clinical features and treatment outcome. Br J Cancer. 2005;92:1226–30.CrossRefPubMed Lee J, et al. Nasal-type NK/T cell lymphoma: clinical features and treatment outcome. Br J Cancer. 2005;92:1226–30.CrossRefPubMed
33.
go back to reference Li YX, et al. Radiotherapy as primary treatment for stage IE and IIE nasal natural killer/T-cell lymphoma. J Clin Oncol. 2006;24:181–9.CrossRefPubMed Li YX, et al. Radiotherapy as primary treatment for stage IE and IIE nasal natural killer/T-cell lymphoma. J Clin Oncol. 2006;24:181–9.CrossRefPubMed
34.
go back to reference Li YX, et al. Primary non-Hodgkin’s lymphoma of the nasal cavity: prognostic significance of paranasal extension and the role of radiotherapy and chemotherapy. Cancer. 1998;83:449–56.CrossRefPubMed Li YX, et al. Primary non-Hodgkin’s lymphoma of the nasal cavity: prognostic significance of paranasal extension and the role of radiotherapy and chemotherapy. Cancer. 1998;83:449–56.CrossRefPubMed
35.
go back to reference Lee KW, et al. First-line ifosfamide, methotrexate, etoposide and prednisolone chemotherapy ± radiotherapy is active in stage I/II extranodal NK/T-cell lymphoma. Leuk Lymphoma. 2006;47:1274–82.CrossRefPubMed Lee KW, et al. First-line ifosfamide, methotrexate, etoposide and prednisolone chemotherapy ± radiotherapy is active in stage I/II extranodal NK/T-cell lymphoma. Leuk Lymphoma. 2006;47:1274–82.CrossRefPubMed
36.
go back to reference Kim TM, et al. Local tumor invasiveness is more predictive of survival than International Prognostic Index in stage IE/IIE extranodal NK/T-cell lymphoma, nasal type. Blood. 2005;106:3785–90.CrossRefPubMed Kim TM, et al. Local tumor invasiveness is more predictive of survival than International Prognostic Index in stage IE/IIE extranodal NK/T-cell lymphoma, nasal type. Blood. 2005;106:3785–90.CrossRefPubMed
37.
go back to reference Shim SJ, et al. Clinical significance of cyclooxygenase-2 expression in extranodal natural killer (NK)/T-cell lymphoma, nasal type. Int J Radiat Oncol Biol Phys. 2007;67:31–8.PubMed Shim SJ, et al. Clinical significance of cyclooxygenase-2 expression in extranodal natural killer (NK)/T-cell lymphoma, nasal type. Int J Radiat Oncol Biol Phys. 2007;67:31–8.PubMed
38.
go back to reference Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the committee on Hodgkin’s disease staging classification. Cancer Res. 1971;31:1860–1.PubMed Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the committee on Hodgkin’s disease staging classification. Cancer Res. 1971;31:1860–1.PubMed
39.
go back to reference Chim CS, et al. Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index. Blood. 2004;103:216–21.CrossRefPubMed Chim CS, et al. Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index. Blood. 2004;103:216–21.CrossRefPubMed
40.
go back to reference Armitage J, Vose J, Weisenburger D. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol. 2008;26:4124–30.CrossRefPubMed Armitage J, Vose J, Weisenburger D. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol. 2008;26:4124–30.CrossRefPubMed
Metadata
Title
Treatment outcome of radiotherapy alone versus radiochemotherapy in early stage nasal natural killer/T-cell lymphoma
Authors
Hui-Hui Ma
Li-Ting Qian
Hai-Feng Pan
Lin Yang
Hong-Yan Zhang
Zhi-Hua Wang
Jun Ma
Yu-Fei Zhao
Jin Gao
Ai-Dong Wu
Publication date
01-09-2010
Publisher
Springer US
Published in
Medical Oncology / Issue 3/2010
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-009-9288-7

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