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Leuk Res. 2016 Oct;49:80-7. doi: 10.1016/j.leukres.2016.08.015. Epub 2016 Aug 31.

Clinical impact of induction treatment modalities and optimal timing of radiotherapy for the treatment of limited-stage NK/T cell lymphoma.

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Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea.
Division of Hematology, Department of Internal Medicine, St. Vincent's hospital, The Catholic University of Korea, Suwon, Republic of Korea.
Department of Hematology/Oncology, Chonbuk National University Hospital, Jeonju, Republic of Korea.
Department of Hematology/Oncology, Dongsan Medical Center, Daegu, Republic of Korea.
Department of Hematology/Oncology, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Hematology-Oncology, Pusan National University Hospital, Pusan, Republic of Korea.
Department of Medical Science, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea. Electronic address:


This study retrospectively investigated the optimal timing of radiotherapy (RT) in patients with limited-stage extranodal NK/T-cell lymphoma (ENTKL). Among 158 patients with newly diagnosed stage I/II ENKTL, 61 patients were treated with sequential chemotherapy followed by radiotherapy (SCRT), 55 with concurrent chemoradiotherapy followed by non-anthracycline-based chemotherapy (CCRT/CT), and 42 with chemotherapy (CT) only. The 5-year overall survival (OS) rate did not differ between SCRT (77.7±5.5%) and CCRT/CT (68.9±6.8%; p=0.234). In the SCRT group, 18 patients (29.5%) relapsed within the RT field and 6 (9.8%) at systemic sites, while in the CCRT/CT group, 9 patients (16.4%) relapsed at the primary site and 14 (25.5%) at systemic sites. The 5-year cumulative incidence of relapse (CIR) at primary sites was 26.3% and 19.2% after SCRT and CCRT/CT (p=0.308), while the 5-year CIR of systemic sites was 8.7% and 26.5% after SCRT and CCRT/CT, respectively (p=0.010). In the multivariate analysis, NK/T-cell Prognostic Index score and CR achievement were the most important prognostic factors for survival. Although up-front RT had limitations in systemic disease control and was associated with an increased risk of systemic relapse during RT compared to SCRT, timing of RT did not significantly affect survival outcomes.


Chemotherapy; Extranodal NK/T cell lymphoma; Radiotherapy; Relapse

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