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

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.

• 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
• Journal: Annals of hematology (Ann Hematol) Vol. 93 Issue 11 Pg. 1895-901 (Nov 2014) ISSN: 1432-0584 [Electronic] Germany
• PMID: 24947798 (Publication Type: Clinical Trial, Phase II, Journal Article)

Chemical References

• Asparaginase

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Asparaginase (administration & dosage)
• Chemoradiotherapy (methods)
• Drug Administration Schedule
• Female
• Humans
• Lymphoma, Extranodal NK-T-Cell (diagnosis, drug therapy, radiotherapy)
• Male
• Middle Aged
• Survival Rate (trends)
• Young Adult