Three-dimensional conformal radiotherapy plus concurrent DICE chemotherapy for early-stage nasal-type natural killer/T-cell lymphoma of Waldeyer’s ring: A single-institution study

摘要

Objective Nasal-type natural killer/T-cell lymphoma of Waldeyer’s ring（WR-NK/TL） has different clinicopathological characteristics from those of other subtypes of NK/T lymphoma; thus, the optimal treatment remains unclear. To find a more effective treatment model for WR-NK/TL, we conducted a single-center study of concurrent radiochemotherapy.Methods Forty-five patients with newly diagnosed stage IE to IIE WR-NKTL were randomly divided into two groups. The 23 cases in the concurrent radiochemotherapy group were treated with three-dimensional conformal radiotherapy（48–52 Gy） and 2 courses of DICE（dexamethasone, ifosfamide, cisplatin, and etoposide） synchronous chemotherapy. The 22 cases in the radiotherapy group only received three-dimensional conformal radiotherapy（50–54 Gy）. The primary end points were overall survival（OS）, progressionfree survival（PFS）, and toxicity.Results The 1-, 3-, and 4-year OS and PFS rates were 95.5%, 65.6%, and 45.9%, and 86.4%, 56.0%, and 46.7% in the radiotherapy group, and 100%, 88.5%, and 88.5%, and 100%, 82.0%, and 73.8% in the concurrent radiochemotherapy group, respectively. The OS（P = 0.0477） and PFS rates（P = 0.0488） were higher in the concurrent radiochemotherapy group than in the radiotherapy group. The overall response rate was 100% in both the radiotherapy group [complete response（CR）, 18 cases] and concurrent radiochemotherapy group（CR, 22 cases）. The concurrent radiochemotherapy group had more severe side effects, especially grade 3 + 4 events, such as leukopenia, anorexia, and stomatitis. However, side effects benefiting from excellent oral care were endurable.Conclusion Radiotherapy plus concurrent DICE chemotherapy may be an effective and safe comprehensive treatment for patients with WR-NKTL.