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Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study

Authors
 Seok Jin Kim  ;  Kihyun Kim  ;  Byung Soo Kim  ;  Chul Yong Kim  ;  Cheolwon Suh  ;  Jooryung Huh  ;  Sang-Wook Lee  ;  Jin Seok Kim  ;  Jaeho Cho  ;  Gyeong-Won Lee  ;  Ki Mun Kang  ;  Hyeon Seok Eom  ;  Hong Ryull Pyo  ;  Yong Chan Ahn  ;  Young Hyeh Ko  ;  Won Seog Kim 
Citation
 JOURNAL OF CLINICAL ONCOLOGY, Vol.27(35) : 6027-6032, 2009 
Journal Title
 JOURNAL OF CLINICAL ONCOLOGY 
ISSN
 0732-183X 
Issue Date
2009
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Chemotherapy, Adjuvant ; Cisplatin/administration & dosage ; Dexamethasone/administration & dosage ; Disease-Free Survival ; Etoposide/administration & dosage ; Female ; Humans ; Ifosfamide/administration & dosage ; Kaplan-Meier Estimate ; Lymphoma, Extranodal NK-T-Cell/drug therapy* ; Lymphoma, Extranodal NK-T-Cell/mortality ; Lymphoma, Extranodal NK-T-Cell/pathology ; Lymphoma, Extranodal NK-T-Cell/radiotherapy* ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Nose Neoplasms/drug therapy* ; Nose Neoplasms/mortality ; Nose Neoplasms/radiotherapy* ; Nose Neoplasms/secondary ; Prospective Studies ; Radiotherapy, Adjuvant ; Republic of Korea ; Risk Assessment ; Time Factors ; Treatment Outcome ; Young Adult
Abstract
PURPOSE: On the basis of the benefits of frontline radiation in early-stage, extranodal, natural killer (NK)/T-cell lymphoma (ENKTL), we conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by three cycles of etoposide, ifosfamide, cisplatin, and dexamethasone (VIPD). PATIENTS AND METHODS: Thirty patients with newly diagnosed, stages IE to IIE, nasal ENKTL received CCRT (ie radiation 40 to 52.8 Gy and cisplatin 30 mg/m(2) weekly). Three cycles of VIPD (etoposide 100 mg/m(2) days 1 through 3, ifosfamide 1,200 mg/m(2) days 1 through 3, cisplatin 33 mg/m(2) days 1 through 3, and dexamethasone 40 mg days 1 through 4) were scheduled after CCRT. RESULTS: All patients completed CCRT, which resulted in 100% response that included 22 complete responses (CRs) and eight partial responses (PRs). The CR rate after CCRT was 73.3% (ie, 22 of 30 responses; 95% CI, 57.46 to 89.13). Twenty-six of 30 patients completed the planned three cycles of VIPD, whereas four patients did not because they withdrew (n = 2) or because they had an infection (n = 2). The overall response rate and the CR rate were 83.3% (ie; 25 of 30 responses; 95% CI, 65.28 to 94.36) and 80.0% (ie, 24 of 30 responses; 95% CI, 65.69 to 94.31), respectively. Only one patient experienced grade 3 toxicity during CCRT (nausea), whereas 12 of 29 patients experienced grade 4 neutropenia. The estimated 3-year, progression-free and overall survival rates were 85.19% (95% CI, 72.48 to 97.90) and 86.28% (95% CI, 73.97 to 98.59), respectively. CONCLUSION: Patients with newly diagnosed, stages IE to IIE, nasal ENKTL are best treated with frontline CCRT.
Files in This Item:
T200905016.pdf Download
DOI
10.1200/JCO.2009.23.8592
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105674
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