文章：

同步调强放疗联合每周顺铂，继以GDP方案化疗，用于初诊IE至IIE期鼻型结外NK/T细胞淋巴瘤

Concurrent IMRT and weekly cisplatin followed by GDP chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell lymphoma

原文发布日期：2014-12-12

DOI: 10.1038/bcj.2014.88

类型: Original Article

开放获取: 是

英文摘要：

On the basis of the benefits of frontline radiation in early-stage, extranodal natural killer (NK)/T-cell lymphoma (ENKTL), we conducted the trial of concurrent chemoradiotherapy (CCRT) followed by three cycles of gemcitabine, dexamethasone and cisplatin (GDP). Thirty-two patients with newly diagnosed, stage IE to IIE, nasal ENKTL received CCRT (that is, all patients received intensity-modulated radiotherapy 56 Gy and cisplatin 30 mg/m2 weekly, 3–5 weeks). Three cycles of GDP (gemcitabine 1000 mg/m2 intravenously (i.v.) on days 1 and 8, dexamethasone 40 mg orally on days 1–4 and cisplatin 75 mg/m2 i.v. on day 1 (GDP), every 21 days as an outpatient were scheduled after CCRT. All patients completed CCRT, which resulted in 100% response that included 24 complete responses (CRs) and eight partial responses. The CR rate after CCRT was 75.0% (that is, 24 of 32 responses). Twenty-eight of the 32 patients completed the planned three cycles of GDP, whereas four patients did not because they withdrew (n=1) or because they had an infection (n=3). The overall response rate and the CR rate were 90.6% (that is, 29 of 32 responses) and 84.4% (that is, 27 of 32 responses), respectively. Only two patient experienced grade 3 toxicity during CCRT (nausea), whereas 13 of the 30 patients experienced grade 4 neutropenia. The estimated 3-year overall survival and progression-free rates were 87.50% and 84.38%, respectively. In conclusion, CCRT followed by GDP chemotherapy can be a feasible and effective treatment strategy for stage IE to IIE nasal ENKTL.

摘要翻译： 

基于早期结外自然杀伤（NK）/T细胞淋巴瘤（ENKTL）中前线放疗的获益，我们开展了一项同步放化疗（CCRT）后续接三个周期吉西他滨、地塞米松和顺铂（GDP）方案的临床试验。32例新诊断的IE至IIE期鼻腔ENKTL患者接受CCRT（即所有患者均接受56Gy调强放疗联合每周30mg/m²顺铂，持续3-5周）。CCRT结束后计划门诊给予三个周期GDP方案（吉西他滨1000mg/m²静脉注射第1、8天，地塞米松40mg口服第1-4天，顺铂75mg/m²静脉注射第1天，每21天为一周期）。所有患者均完成CCRT，总缓解率达100%，包括24例完全缓解和8例部分缓解。CCRT后完全缓解率为75.0%（即32例患者中24例缓解）。32例患者中28例完成计划的三周期GDP化疗，4例未完成（1例退出，3例因感染中断）。总体缓解率和完全缓解率分别为90.6%（32例中29例缓解）和84.4%（32例中27例缓解）。CCRT期间仅2例患者出现3级毒性反应（恶心），而30例患者中13例出现4级中性粒细胞减少。预估3年总生存率和无进展生存率分别为87.50%和84.38%。结论：CCRT后续接GDP化疗是IE至IIE期鼻腔ENKTL可行且有效的治疗策略。

原文链接：

Concurrent IMRT and weekly cisplatin followed by GDP chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell lymphoma