强化治疗可改善新诊断晚期结外 NK/T 细胞淋巴瘤的长期生存：一项多机构真实世界研究

The study investigated the treatment and prognosis of advanced-stage extranodal natural killer/T-cell lymphoma (ENKTL). With a median follow-up of 75. 03 months, the median overall survival (mOS) for the 195 newly diagnosed stage III/IV ENKTL patients was 19. 43 months, and estimated 1-, 2-, 3- and 5-year OS were 59. 5%, 46. 3%, 41. 8% and 35. 1%, respectively. Chemotherapy (CT) + radiotherapy (RT) compared to CT alone (P = . 007), and hematopoietic stem cell transplantation (HSCT) compared to non-HSCT (P < . 001), both improved OS. For patients ≤60 years and ineligible for HSCT, other therapies with complete remission led to comparable OS (P = . 141). Nine patients ever treated with chidamide achieved a median progression-free survival (mPFS) and mOS of 53. 63 (range, 3. 47-92. 33) and 54. 80 (range, 5. 50-95. 70) months, and four with chidamide maintenance therapy (MT) achieved a mPFS and mOS of 55.

83 (range, 53. 27-92. 33) and 60. 65 (range, 53. 70-95. 70) months, possibly providing an alternative option for non-HSCT patients. Non-anthracycline (ANT)- compared to ANT-, asparaginase (Aspa)- compared to non-Aspa- and gemcitabine (Gem)- compared to non-Gem-based regimens, prolonged PFS (P = . 031; P = . 005; P = . 009) and OS (P = . 010; P = . 086; P = . 003), respectively. Multivariate analysis demonstrated that Gem-based regimens improved PFS (HR = 0.

691, P = . 061) and OS (HR = 0. 624, P = . 037). Gem + Aspa combinations slightly improved PFS and OS compared to regimens containing Gem or Aspa alone (P > 0. 05). First-line "intensive therapy," including CT (particularly Gem + Aspa regimens), RT, HSCT and alternative chidamide MT, was proposed and could improve long-term survival for advanced-stage ENKTLs. Ongoing prospective clinical studies may shed further light on the value of chidamide MT.