Radiotherapy and PGEMOX/GELOX regimen improved prognosis in elderly patients with early-stage extranodal NK/T-cell lymphoma
Radiotherapy and PGEMOX/GELOX regimen improved prognosis in elderly patients with early-stage extranodal NK/T-cell lymphoma
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DOI：
10.1007/s00277-015-2395-y
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发表时间：
2015-09-01
影响因子：
3.5
通讯作者：
Li, Zhi-ming
中科院分区：
文献类型：
--
作者：
Bi, Xi-wen;Xia, Yi;Li, Zhi-ming
老年自然杀伤/T细胞淋巴瘤（NKTCL）患者的最佳治疗策略仍有待确定。对63例新诊断的老年NKTCL患者进行回顾性分析。在I-II期疾病患者中，58.3%接受了放疗（RT）+/-化疗，41.7%仅接受化疗。与单纯化疗相比，RT +/-化疗组的总有效率（ORR）显著提高（100 vs. 57.1%，P < 0.001），5年总生存率（OS）显著延长（55.3 vs. 18.0%，P < 0.001）。在I-II期疾病患者中，与其他化疗方案相比，培门冬酶联合吉西他滨和奥沙利铂（PGEMOX）/L-门冬酰胺酶联合吉西他滨和奥沙利铂（GESIX）的ORR显著更高（92.9 vs. 51.6%，P=0.009），5年OS显著改善（78.6 vs. 23.9%，P=0.010）。9名I-II期患者接受PGEMOX/GRENIX治疗后接受RT治疗，结果令人鼓舞（5年OS 100%，5年无进展生存期（PFS）85.7%），上级接受其他方案后接受RT的患者。总之，RT在老年早期NKTCL患者中发挥了重要作用，PGEMOX/GREX方案上级优于其他方案。它们的组合可能是一个有前途的治疗选择。
The optimal treatment strategy for elderly patients with natural killer/T-cell lymphoma (NKTCL) remains to be established. A total of 63 elderly patients with newly diagnosed NKTCL were retrospectively reviewed. Among the patients with stage I-II disease, 58.3 % received radiotherapy (RT) +/- chemotherapy, and 41.7 % received chemotherapy alone. Compared with chemotherapy alone, RT +/- chemotherapy elicited a significantly higher overall response rate (ORR) (100 vs. 57.1 %, P < 0.001) and substantially prolonged 5-year overall survival (OS) (55.3 vs. 18.0 %, P < 0.001) in patients with stage I-II disease. Compared with other chemotherapeutic regimens, pegaspargase plus gemcitabine and oxaliplatin (PGEMOX)/L-asparaginase plus gemcitabine and oxaliplatin (GELOX) was associated with a significantly higher ORR (92.9 vs. 51.6 %, P=0.009) and a significantly improved 5-year OS (78.6 vs. 23.9 %, P=0.010) in patients with stage I-II disease. Nine patients with stage I-II disease who were treated with PGEMOX/GELOX followed by RT had an encouraging outcome (5-year OS 100 %, 5-year progression-free survival (PFS) 85.7 %), which was superior to that of patients receiving other regimens followed by RT. In conclusion, RT played an important role for elderly patients with early-stage NKTCL, and the PGEMOX/GELOX regimen was superior to other regimens. The combination of them may be a promising treatment option.