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Concurrent chemoradiotherapy followed by L-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma: CISL08-01 phase II study

Authors
 Seok Jin Kim  ;  Deok-Hwan Yang  ;  Jin Seok Kim  ;  Jae-Yong Kwak  ;  Hyeon-Seok Eom  ;  Dae Sik Hong  ;  Jong Ho Won  ;  Jae Hoon Lee  ;  Dok Hyun Yoon  ;  Jaeho Cho  ;  Taek-Keun Nam  ;  Sang-wook Lee  ;  Yong Chan Ahn  ;  Cheolwon Suh  ;  Won Seog Kim 
Citation
 ANNALS OF HEMATOLOGY, Vol.93(11) : 1895-1901, 2014 
Journal Title
 ANNALS OF HEMATOLOGY 
ISSN
 0939-5555 
Issue Date
2014
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage* ; Asparaginase/administration & dosage* ; Chemoradiotherapy/methods* ; Drug Administration Schedule ; Female ; Humans ; Lymphoma, Extranodal NK-T-Cell/diagnosis ; Lymphoma, Extranodal NK-T-Cell/drug therapy* ; Lymphoma, Extranodal NK-T-Cell/radiotherapy* ; Male ; Middle Aged ; Survival Rate/trends ; Young Adult
Keywords
Extranodal NK/T cell lymphoma ; Chemotherapy ; Radiotherapy ; l-Asparaginase
Abstract
We conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by 2 cycles of L-asparaginase-containing chemotherapy for patients who were newly diagnosed with stages IE and IIE nasal extranodal NK/T cell lymphoma (ENKTL). CCRT consisted of 40-44 Gy of radiotherapy with weekly administration of 30 mg/m(2) of cisplatin for 4 weeks. Two cycles of VIDL (etoposide (100 mg/m(2)), ifosfamide (1,200 mg/m(2)), and dexamethasone (40 mg) from days 1 to 3, and L-asparaginase (4,000 IU/m(2)) every other day from days 8 to 20) were administered sequentially. CCRT yielded a 90 % overall response rate without significant side effects in 30 patients, including 20 patients with complete response (CR); however, two patients showed distant disease progression. After CCRT, VIDL chemotherapy showed an 87 % final CR rate (26/30). Although grade III or IV hematologic toxicity was frequent during VIDL chemotherapy, no treatment-related mortality was observed, and L-asparaginase-associated toxicity was manageable. With a median follow-up of 44 months, 11 patients showed local (n = 4) and distant (n = 7) relapse or progression. The estimated 5-year progression-free and overall survival rates were 73 and 60 %, respectively. In conclusion, CCRT followed by L-asparaginase-containing chemotherapy is a feasible treatment for newly diagnosed stages IE/IIE nasal ENKTL.
Full Text
http://link.springer.com/article/10.1007%2Fs00277-014-2137-6
DOI
10.1007/s00277-014-2137-6
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/22282913/138717
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