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Cancer Med. 2019 Jul;8(7):3349-3358. doi: 10.1002/cam4.2214. Epub 2019 May 2.

Gemcitabine, dexamethasone, and cisplatin (GDP) chemotherapy with sandwiched radiotherapy in the treatment of newly diagnosed stage IE/IIE extranodal natural killer/T-cell lymphoma, nasal type.

Tian S1,2,3, Li R1, Wang T1, Wang S1, Tao R4, Hu X2,3, Ding H1.

Author information

1
Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
2
Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
3
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
4
Department of Hematology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Abstract

Extranodal natural killer/T-cell lymphoma (ENKL), nasal-type is a rare but highly aggressive disease with poor prognosis. Optimal treatment strategies for newly diagnosed localized ENKL have not been fully defined. Here we retrospectively analyzed 72 patients with newly diagnosed stage IE/IIE ENKL treated with gemcitabine, dexamethasone, and cisplatin (GDP) regimen chemotherapy with sandwiched radiotherapy in our department between May 2012 and September 2014. After 2 cycles of GDP induction chemotherapy, the complete response rate (CRR) and overall response rate (ORR) were 30.6% (22/72) and 91.7% (66/72). After whole treatment completion, the CRR and ORR were 81.9% (59/72) and 91.7% (66/72), respectively. With a median follow-up of 57.8 months (Interquartile Range 54.0-64.5 months), the 5-year progression-free survival rate was 70.9% (95% CI, 60.1% to 81.7%), and the 5-year overall survival rate was 72.0% (95% CI, 61.6% to 82.4%), respectively. Patients with CRR after treatment had better prognosis than their counterparts. The major adverse events were myelosuppression, liver dysfunction, gemcitabine-related skin rash, and digestive tract toxicities. Grade 3 to 4 neutropenia and thrombocytopenia were 18.0% (13/72) and 15.3% (11/72), respectively. No treatment related deaths were observed. It is concluded that the GDP regimen with sandwiched radiotherapy was an effective and well-tolerated treatment for newly diagnosed stage IE/IIE ENKL, nasal-type.

KEYWORDS:

GDP regimen; chemotherapy; extranodal natural killer/T cell lymphoma; gemcitabine; nasal-type; radiotherapy

PMID:
31050212
DOI:
10.1002/cam4.2214
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