Curability Of Radiotherapy In Elderly Patients With Earlystage Extranodal Nasal-Type Nk/T-Cell Lymphoma: A Multicenter Study From The China Lymphoma Collaborative Group (Clcg)
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS(2018)
摘要
The purpose of the present study was to determine the curability of radiotherapy and potential benefit of a new chemotherapy regimen in elderly patients with early-stage extranodal nasal-type NK/T-cell lymphoma (NKTCL). In a multicenter study, 321 elderly patients (age > 60 years) with early-stage NKTCL were reviewed retrospectively. Patients received radiotherapy alone (n = 87), chemotherapy alone (n = 59), or combined modality therapy (CMT, n = 175). Patients were classified into groups of either low- or high-risk using four prognostic factors. Observed survival in the study cohort versus expected survival in the age- and sex- matched general Chinese population was plotted by using a conditional approach and compared by standardized mortality ratio (SMR). Radiotherapy achieved a favorable prognosis in elderly early-stage patients and significantly improved prognosis compared with chemotherapy alone. The 5-year overall survival (OS) and progression-free survival (PFS) were 61.2% and 56.4% for radiotherapy compared with 44.7% and 38.3% for chemotherapy alone ( P < 0.001). Low-risk patients showed significantly improved survival compared with high-risk patients. Patients treated with a new CMT regimen demonstrated a significantly improved PFS compared with the old CMT regimen (71.2% vs. 44.2%, respectively, P = 0.017). Low-risk patients following radiotherapy (SMR, 0.703; P = 0.203) and high-risk patients that achieved PFS at 24 months (SMR, 1.490; P = 0.111) after radiotherapy showed survival equivalent to the general Chinese population. Our findings highlight the curability of radiotherapy and provide a risk-adapted follow-up and counsel system for elderly early-stage patients.
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