Senzo Taguchi, MD, PhD
No relationships to disclose.
PD 08 - Hematologic 1 - Poster Discussion
Purpose/Objective(s): To investigate the significance of primary tumor invasion (PTI) and soluble interleukin-2 receptor (sIL-2R) as prognostic factors for the patients with localized nasal NK/T-cell Lymphoma (ENKL) treated with radiation therapy with or without chemotherapy in Japan.
Materials/Methods: This study was conducted from the multi-institutional retrospective series of the Next-Generation therapy for NK/T-cell lymphoma in East Asia (NKEA) project data base with collaboration among Japanese hemato-oncologists and Japanese Radiation Oncology Study Group (JROSG) in Japan. There were retrospective series of patients treated with radiation therapy with or without chemotherapy between 2000 and 2013. The clinical target volume (CTV) of all patients was evaluated by the board certified radiation oncologists belonging to the JROSG lymphoma committee. PTI was evaluated by the two radiation oncologists. The overall survival rate (OS), progression free survival rate (PFS), and loco-regional control rate (LRC) were calculated using Kaplan-Meier method. We also investigated prognostic factors including PTI and sIL-2R using the log-rank test and hazard radio (HR) by Cox regression model.
Results: One hundred sixty four newly diagnosed ENKL patients of stage I or ll disease were selected. The majority of patients (72.6%) were treated with concurrent chemoradiation using dexamethasone, etoposide, ifosfamide, and carboplatin (RT-DeVIC). Median age of the total patients was 58 years (range: 17-88 years). Among the 86 patients (52.4%) who could evaluate the PTI, majority of patients (80.2%) had PTI. Median follow up time was 4.7 years (range: 0.6-13.9 years). The 5-year OS, PFS, LRC for total patients and RT-DeVIC group were 72.1%, 59.1%, 81.8%, and 73.2%, 64.4%, 86.1%, respectively. The univariate analysis revealed that the risk of PTI had significantly worse outcome in PFS in RT-DeVIC group (P = 0.041). However, PTI is not statistically significant in the multivariate analysis. Multivariate analysis revealed that elevated sIL-2R was an independent prognostic factor for worse OS (P = 0.003; HR, 2.983; 95% CI, 1.453 to 6.124), PFS (P < 0.001; HR, 2.627; 95% CI, 1.532 to 4.504), and LRC (P = 0.021; HR, 3.026; 95% CI, 1.181 to 7.751) in total patients. Elevated sIL-2R was also statistically significant in RT-DeVIC group for OS, PFS, and LRC. Other independent prognostic factors in the total patients were smaller CTV for worse LRC and the Age > 60 years for worse OS.
Conclusion: Our statistical significance of PTI on localized nasal ENKL was weak, because the majority of Japanese patients showed positive PTI. Elevated sIL-2R may be useful to predict the outcome for localized nasal ENKL patients with positive PTI in Japan.
No relationships to disclose.
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