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Association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type NK/T-cell lymphoma: a CLCG study
BACKGROUND: This study evaluated the survival benefit of asparaginase (ASP)-based versus non-ASP-based chemotherapy combined with radiotherapy in a real-world cohort of patients with early-stage extranodal nasal-type natural killer/T-cell lymphoma (ENKTCL). PATIENTS AND METHODS: We identified 376 pa...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8271122/ https://www.ncbi.nlm.nih.gov/pubmed/34242966 http://dx.doi.org/10.1016/j.esmoop.2021.100206 |
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author | Zheng, X. He, X. Yang, Y. Liu, X. Zhang, L.L. Qu, B.L. Zhong, Q.Z. Qian, L.T. Hou, X.R. Qiao, X.Y. Wang, H. Zhu, Y. Cao, J.Z. Wu, J.X. Wu, T. Zhu, S.Y. Shi, M. Xu, L.M. Zhang, H.L. Su, H. Song, Y.Q. Zhu, J. Zhang, Y.J. Huang, H.Q. Wang, Y. Chen, F. Yin, L. Qi, S.N. Li, Y.X. |
author_facet | Zheng, X. He, X. Yang, Y. Liu, X. Zhang, L.L. Qu, B.L. Zhong, Q.Z. Qian, L.T. Hou, X.R. Qiao, X.Y. Wang, H. Zhu, Y. Cao, J.Z. Wu, J.X. Wu, T. Zhu, S.Y. Shi, M. Xu, L.M. Zhang, H.L. Su, H. Song, Y.Q. Zhu, J. Zhang, Y.J. Huang, H.Q. Wang, Y. Chen, F. Yin, L. Qi, S.N. Li, Y.X. |
author_sort | Zheng, X. |
collection | PubMed |
description | BACKGROUND: This study evaluated the survival benefit of asparaginase (ASP)-based versus non-ASP-based chemotherapy combined with radiotherapy in a real-world cohort of patients with early-stage extranodal nasal-type natural killer/T-cell lymphoma (ENKTCL). PATIENTS AND METHODS: We identified 376 patients who received combined radiotherapy with either ASP-based (ASP, platinum, and gemcitabine; n = 286) or non-ASP-based (platinum and gemcitabine; n = 90) regimens. The patients were stratified into low-, intermediate-, and high-risk groups using the early stage-adjusted nomogram-revised risk index. Overall survival (OS) and distant metastasis (DM)-free survival (DMFS) between the chemotherapy regimens were compared using inverse probability of treatment weighting (IPTW) and multivariable analyses. RESULTS: ASP-based (versus non-ASP-based) regimens significantly improved 5-year OS (84.5% versus 73.2%, P = 0.021) and DMFS (84.4% versus 74.5%, P = 0.014) for intermediate- and high-risk patients, but not for low-risk patients in the setting of radiotherapy. Moreover, ASP-based regimens decreased DM, with a 5-year cumulative DM rate of 14.9% for ASP-based regimens compared with 25.1% (P = 0.014) for non-ASP-based regimens. The survival benefit of ASP-based chemotherapy and radiotherapy remained consistent after adjusting the confounding variables using IPTW and multivariate analyses; additional sensitivity analyses confirmed these results. CONCLUSIONS: The findings provided support for ASP-based chemotherapy and radiotherapy as a first-line treatment strategy for intermediate- and high-risk early-stage ENKTCL. |
format | Online Article Text |
id | pubmed-8271122 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-82711222021-07-16 Association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type NK/T-cell lymphoma: a CLCG study Zheng, X. He, X. Yang, Y. Liu, X. Zhang, L.L. Qu, B.L. Zhong, Q.Z. Qian, L.T. Hou, X.R. Qiao, X.Y. Wang, H. Zhu, Y. Cao, J.Z. Wu, J.X. Wu, T. Zhu, S.Y. Shi, M. Xu, L.M. Zhang, H.L. Su, H. Song, Y.Q. Zhu, J. Zhang, Y.J. Huang, H.Q. Wang, Y. Chen, F. Yin, L. Qi, S.N. Li, Y.X. ESMO Open Original Research BACKGROUND: This study evaluated the survival benefit of asparaginase (ASP)-based versus non-ASP-based chemotherapy combined with radiotherapy in a real-world cohort of patients with early-stage extranodal nasal-type natural killer/T-cell lymphoma (ENKTCL). PATIENTS AND METHODS: We identified 376 patients who received combined radiotherapy with either ASP-based (ASP, platinum, and gemcitabine; n = 286) or non-ASP-based (platinum and gemcitabine; n = 90) regimens. The patients were stratified into low-, intermediate-, and high-risk groups using the early stage-adjusted nomogram-revised risk index. Overall survival (OS) and distant metastasis (DM)-free survival (DMFS) between the chemotherapy regimens were compared using inverse probability of treatment weighting (IPTW) and multivariable analyses. RESULTS: ASP-based (versus non-ASP-based) regimens significantly improved 5-year OS (84.5% versus 73.2%, P = 0.021) and DMFS (84.4% versus 74.5%, P = 0.014) for intermediate- and high-risk patients, but not for low-risk patients in the setting of radiotherapy. Moreover, ASP-based regimens decreased DM, with a 5-year cumulative DM rate of 14.9% for ASP-based regimens compared with 25.1% (P = 0.014) for non-ASP-based regimens. The survival benefit of ASP-based chemotherapy and radiotherapy remained consistent after adjusting the confounding variables using IPTW and multivariate analyses; additional sensitivity analyses confirmed these results. CONCLUSIONS: The findings provided support for ASP-based chemotherapy and radiotherapy as a first-line treatment strategy for intermediate- and high-risk early-stage ENKTCL. Elsevier 2021-07-07 /pmc/articles/PMC8271122/ /pubmed/34242966 http://dx.doi.org/10.1016/j.esmoop.2021.100206 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Zheng, X. He, X. Yang, Y. Liu, X. Zhang, L.L. Qu, B.L. Zhong, Q.Z. Qian, L.T. Hou, X.R. Qiao, X.Y. Wang, H. Zhu, Y. Cao, J.Z. Wu, J.X. Wu, T. Zhu, S.Y. Shi, M. Xu, L.M. Zhang, H.L. Su, H. Song, Y.Q. Zhu, J. Zhang, Y.J. Huang, H.Q. Wang, Y. Chen, F. Yin, L. Qi, S.N. Li, Y.X. Association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type NK/T-cell lymphoma: a CLCG study |
title | Association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type NK/T-cell lymphoma: a CLCG study |
title_full | Association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type NK/T-cell lymphoma: a CLCG study |
title_fullStr | Association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type NK/T-cell lymphoma: a CLCG study |
title_full_unstemmed | Association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type NK/T-cell lymphoma: a CLCG study |
title_short | Association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type NK/T-cell lymphoma: a CLCG study |
title_sort | association of improved overall survival with decreased distant metastasis following asparaginase-based chemotherapy and radiotherapy for intermediate- and high-risk early-stage extranodal nasal-type nk/t-cell lymphoma: a clcg study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8271122/ https://www.ncbi.nlm.nih.gov/pubmed/34242966 http://dx.doi.org/10.1016/j.esmoop.2021.100206 |
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