早期结外 NK/T 细胞淋巴瘤序贯 P-GEMOX 和放疗：一项多中心研究

Extranodal natural killer/T-cell lymphoma, nasal-type (ENKTL) is a distinct subtype of non-Hodgkin lymphoma and most of the patients presented localized disease. Combined modality therapy (CMT), namely chemotherapy combined with radiotherapy, has been recommended for patients with early-stage ENKTL.

However, the optimal CMT has not been fully clarified. This study reports the efficacy and toxicity of sequential P-GEMOX (pegaspargase, gemcitabine and oxaliplatin) and radiotherapy in a large Chinese cohort comprising of 202 patients diagnosed with early-stage ENKTL from six medical centers. The observed best overall response rate was 96. 0% and 168 (83. 2%) patients achieved complete remission. With a median follow-up of 44. 1 months, the 3-year progression-free survival (PFS) and overall survival (OS) were 74. 6% and 85. 2%, respectively. Multivariate analysis suggested that extensive primary tumor (PFS, hazard ratio [HR] 3.

660, 95% CI 1. 820-7. 359, p < 0. 001; OS, HR 3. 825, 95% CI 1. 442-10. 148, p = 0. 007) and Eastern Cooperative Oncology Group performance status ≥ 2 (PFS, 3. 042, 95% CI 1. 468-6. 306, p = 0. 003; OS, HR 3. 983, 95% CI 1. 678-9. 457, p = 0. 02) were independent prognostic factors for survival outcomes.

Among the established prognostic models for ENKTL, the nomogram-revised risk index model had optimal prognostic risk stratification ability (PFS, p < 0. 001; OS, p < 0. 001) and relatively balanced population distribution. The adverse events of this CMT were well-tolerated and manageable.

In conclusion, sequential P-GEMOX and radiotherapy showed favorable efficacy with acceptable toxicity, and could be an effective treatment option for early-stage ENKTL patients.