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Radiotherapy improves locoregional control, survival in natural-killer/T-cell lymphoma
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Radiotherapy significantly improved locoregional control in patients with early-stage extranodal natural killer/T-cell lymphoma, thereby improving PFS and OS, researchers in China found.
“The standard of care for the most common type of aggressive lymphoma, diffuse large B-cell lymphoma, is chemotherapy with optional radiotherapy. In contrast, natural killer/T-cell lymphoma is radiosensitive but chemoresistant,” Yong Yang, MD, of the National Cancer Center in Beijing, and colleagues wrote. “Radiotherapy is the most effective single modality in terms of locoregional control; however, the long-term survival benefit of radiotherapy in early-stage natural killer/T-cell lymphoma remains a matter of debate due to the frequency of systemic relapse.”
Yang and colleagues reviewed data from 1,332 patients treated for early-stage extranodal natural killer/T-cell lymphoma at 10 Chinese hospitals from 2000 to 2014, and used radiotherapy dose as a continuous variable in a Cox regression model. All patients received either chemotherapy, radiotherapy or a combination of the two.
Median age was 43 years, and 923 patients (69%) were male. Mortality, locoregional recurrence and disease progression all decreased significantly with radiotherapy until a dose of 50 Gy to 52 Gy, the researchers wrote. Radiotherapy had a dose–dependent effect on locoregional control (range, 41%-87%), OS (range, 33%-77%) and PFS (18%-63%).
A dose of 50 Gy or greater was associated with improved 5-year locoregional control compared with a dose of less than 50 Gy (85% vs. 73%; P < .001), along with improved OS (70% vs. 58%; P = .04) and PFS (61% vs. 50%; P = .004). The researchers reported a linear correlation between 5-year locoregional control and 5-year PFS (correlation coefficient, r = 0.994; P < .001; determination coefficient, R2 = 0.988) and 5-year OS (r = 0.985, P = .002; R2 = 0.97).
“Improvements in locoregional control provided by radiotherapy translate into significant PFS and OS benefits in early-stage natural killer/T-cell lymphoma,” the researchers wrote. “Clinicians and patients should be aware of the essential role of radiotherapy in both locoregional disease control and maintaining long-term survival. These findings will help to define the standard of care and assist decision making and prospective clinical trial design.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.
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