Sequential chemotherapy/radiotherapy was comparable with concurrent chemoradiotherapy for stage I/II NK/T-cell lymphoma

Y. L. Kwong, S. J. Kim, E. Tse, S. Y. Oh, J. Y. Kwak, H. S. Eom, Y. R. Do, Y. C. Mun, S. R. Lee, H. J. Shin, C. Suh, S. S. Chuang, Y. S. Lee, S. T. Lim, K. Izutsu, R. Suzuki, T. Relander, F. d'Amore, N. Schmitz, A. JaccardW. S. Kim

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61 Scopus citations


Background: In stage I/II natural killer (NK)/T-cell lymphoma, concurrent chemoradiotherapy (CCRT) had previously been shown to result in superior outcome compared with anthracycline-containing regimens, which have since been considered ineffective. The role of CCRT in comparison with approaches employing nonanthracycline-containing chemotherapy (CT) and sequential radiotherapy (RT) in such patients remains to be defined. Patients and methods: Three hundred and three untreated patients (207 men, 96 women; median age: 51, 18-86 years) with stage I/II NK/T-cell lymphoma who had received nonanthracycline-containing regimens were collected from an international consortium and retrospectively analyzed. Treatment included single modality (CT and RT), sequential modalities (CT+RT; RT+CT) and concurrent modalities (CCRT; CCRT+CT). The impact of clinicopathologic parameters and types of treatment on complete response (CR) rate, progression-free-survival (PFS) and overall-survival (OS) was evaluated. Results: For CR, stage (P=0.027), prognostic index for NK/T-cell lymphoma (PINK) (P=0.026) and types of initial treatment (P=0.011) were significant prognostic factors on multivariate analysis. On Cox regression analysis, ECOG performance score (P=0.021) and PINK-EBV DNA (PINK-E) (P=0.002) significantly impacted on PFS; whereas ECOG performance score (P=0.008) and stage (P<0.001) significantly impacted on OS. For comparing CCRT6CT and sequential CT+RT, CCRT6CT patients (n=190) were similar to sequential CT+RT patients (n=54) in all evaluated clinicopathologic parameters except two significantly superior features (higher proportion of undetectable circulating EBV DNA on diagnosis and lower PINK-E scores). Despite more favorable pre-treatment characteristics, CCRT6CT patients had CR rate, PFS and OS comparable with sequential CT+RT patients on multivariate and Cox regression analyses. Conclusions: In stage I/II NK/T-cell lymphomas, when effective chemotherapeutic regimens were used, CCRT and sequential CT+RT gave similar outcome.

Original languageEnglish
Pages (from-to)256-263
Number of pages8
JournalAnnals of Oncology
Issue number1
StatePublished - 1 Jan 2018

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© The Author 2017.


  • Concurrent chemoradiotherapy
  • Sequential chemotherapy and radiotherapy
  • Stage I/II NK/T-cell lymphomas


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