Radiotherapy followed by DICEP regimen in treatment of newly diagnosed, stage IE/IIE, extranodal NK/T‐cell lymphoma patients

• Published in: Cancer medicine (Malden, MA) MA), 2020-08, Vol.9 (15), p.5400-5405
• Main Authors: Liu, Yizhen, Xue, Kai, Xia, Zuguang, Jin, Jia, Wang, Jiachen, Sun, Hui, Lv, Fangfang, Liu, Xiaojian, Cao, Junning, Hong, Xiaonan, Guo, Ye, Ma, Xuejun, Zhang, Qunling
• Format: Article
• Language: English
• Subjects: Chemotherapy; Cisplatin; Clinical Cancer Research; Dexamethasone; DICE; Disease; Etoposide; Fever; Fibrinogen; Glycoproteins; Ifosfamide; Lymphoma; Natural killer cells; Neutropenia; Neutrophils; NK/T‐cell lymphoma; Original Research; Patients; Pegaspargase; radiation; Radiation therapy; T-cell lymphoma; Toxicity
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.3207

Background The optimal treatment strategies for extranodal natural killer/ T‐cell lymphoma (ENKTL) have not been defined. We conducted this prospective, open‐label, phase II, single‐center study aimed to explore the efficacy and safety of radiotherapy followed by DICEP (Dexamethasone, ifosfamide, cisplatin, etoposide, and pegaspargase) regimen in the treatment of patients with untreated, stage IE/IIE, extranodal NK/T‐cell lymphoma. Methods Thirty eligible patients were enrolled in this study, receiving radiotherapy of 50Gy/25fx, and followed by chemotherapy with DICEP regimen for 3 cycles if tolerated. Median follow‐up time of this study was 70.8 months. We constructed Kaplan‐Meier survival curves for survival analyses. Results The most common manifestations at the onset of disease were nasal obstruction (80%), with or without fever, and pharyngalgia (20%). The overall response rate (ORR) was 96.7% (29/30). Four patients (13.3%) had progression of the disease (PD), the estimated 5‐year progression‐free survival (PFS) rate was 86%. Four patients (13.3%) died of disease, and the estimated 5‐year cumulative overall survival (OS) was 87%. The most common hematological toxicity was grade 3 or grade 4 neutropenia, which could be successfully managed via using growth‐stimulating factors or dose modifications. Hypoalbuminemia and decreased fibrinogen are the top two nonhematologic toxicities. No treatment‐related death occurred in this study. Conclusions Our present study showed that radiotherapy followed by DICEP chemotherapy could be an effective and tolerable treatment modality for newly diagnosed, stage IE/IIE ENKTL patients. Adverse events were predictable and manageable. Trial registration ClinicalTrials.gov Identifier: NCT01667302. Registered: 1 July 2012; The current results indicated that radiotherapy followed by DICEP chemotherapy could be an effective and feasible treatment strategy for patients with stage IE/IIE ENKTL.