Therapeutics and Clinical Risk Management (Dec 2020)
Optimal Courses of Chemotherapy Combined with Radiotherapy for Low-Risk Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type: A Propensity Score Matching Analysis
Abstract
Jin Li,1 Yajun Li,2 Ruolan Zeng,2 Jingguan Lin,1 Meizuo Zhong,3 Xianling Liu,4 Yizi He,2 Junqiao He,2 Zhou Ouyang,2 Lijun Huang,2 Ling Xiao,5 Hui Zhou2 1Department of Comprehensive Chemotherapy/Daytime Chemotherapy, Hunan Cancer Hospital, Changsha, Hunan, People’s Republic of China; 2Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, People’s Republic of China; 3Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 4Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 5Department of Histology and Embryology, School of Basic Medical Science, Central South University, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Hui ZhouDepartment of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, People’s Republic of ChinaTel +86 731 89762281Email [email protected]: This retrospective study compared effectiveness between ≤ 4 cycles and ≥ 5 cycles of L-asparaginase/pegaspargase-based chemoradiation in newly diagnosed low-risk extranodal natural killer/T-cell lymphoma (ENKTL), nasal type classified according to the Prognostic Index of Natural Killer (PINK) lymphoma model.Patients and Methods: Patients were categorized into ≤ 4-cycle (2– 4 chemotherapy cycles, n = 166) and ≥ 5-cycle groups (5– 6 cycles, n = 86). Propensity score matching analysis was used to reduce potential confounding bias between the two groups. Treatment responses, adverse events, and survival outcomes between the two groups were analyzed.Results: No matter before or after matching (65 in the ≤ 4-cycle group, 65 in the ≥ 5-cycle group), response rates and survival outcomes were similar between the ≤ 4-cycle and ≥ 5-cycle groups. Incidences of grade 1– 2 anemia and transaminase elevation were higher in the ≥ 5-cycle group. After matching, for stage IE disease, there were no differences in response rates and survival outcomes between the two groups. For stage IIE disease, the complete response rate was higher in the ≥ 5-cycle group (72.4% vs 92.6%, p = 0.049), and the 3-year overall survival (65.5% vs 85.2%, p = 0.024) and 3-year progression-free survival (58.6% vs 81.5%, p = 0.027) rates were significantly extended in the ≥ 5-cycle group.Conclusion: When chemoradiotherapy strategies with L-asparaginase/pegaspargase-based regimens are applied to modern low-risk ENKTL patients classified according to the PINK model, it may be better to moderately extend chemotherapy courses in patients with stage IIE disease.Keywords: extranodal natural killer/T-cell lymphoma, nasal type, chemotherapy courses, low-risk
