Phase II trial of concurrent chemoradiotherapy with L-asparaginase and MIDLE chemotherapy for newly diagnosed stage I/II extranodal NK/T-cell lymphoma, nasal type (CISL1008)
- Authors
- Yoon, Dok Hyun; Kim, Seok Jin; Jeong, Seong Hyun; Shin, Dong-Yeop; Bae, Sung Hwa; Hong, Junshik; Park, Seong Kyu; Yhim, Ho-Young; Yang, Deok-Hwan; Lee, Hyewon; Kang, Hye Jin; Lee, Mark Hong; Eom, Hyeon-Seok; Kwak, Jae-Yong; Lee, Jae Hoon; Suh, Cheolwon; Kim, Won Seog
- Issue Date
- 20-Dec-2016
- Publisher
- Impact Journals
- Keywords
- extranodal NK/T-cell lymphoma; nasal type; concurrent chemoradiotherapy; L-asparaginase; methotrexate; treatment
- Citation
- Oncotarget, v.7, no.51, pp 85584 - 85591
- Pages
- 8
- Journal Title
- Oncotarget
- Volume
- 7
- Number
- 51
- Start Page
- 85584
- End Page
- 85591
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/8461
- DOI
- 10.18632/oncotarget.11319
- ISSN
- 1949-2553
- Abstract
- We designed a new treatment protocol incorporating concurrent administration of L-asparaginase (to reduce the probability of systemic progression during concurrent chemoradiotherapy (CCRT)) plus high-dose methotrexate to consolidation chemotherapy to intensify the regimen for treating localized extranodal NK/T cell lymphoma, nasal type (ENKTL). CCRT comprised radiation (36-44 Gy) with weekly cisplatin (30 mg/m(2)) and tri-weekly L-asparaginase (4 000 IU). Chemotherapy MIDLE (methotrexate 3 g/m(2) on day 1, etoposide 100 mg/m(2) and Ifosfamide 1 000 mg/m(2) on days 2-3, dexamethasone 40 mg on days 1-4, and L-asparaginase 6 000 IU/m(2) on days 4, 6, 8, 10)-was repeated every 28 days for two cycles. One of the 28 patients developed distant lesions after CCRT. The final complete response rate was 82.1%. Four patients dropped out during or after their first MIDLE cycle due to toxicities (recurrent G3 hyperbilirubinemia [n = 1], G3-5 increased creatinine [n = 2], and G5 infection [n = 1]). With a median follow-up of 46 months (95% CI: 39-47 months), the estimated 3-year progression-free survival rate and overall survival rate were 74.1% and 81.5%, respectively. This MIDLE protocol may be effective for localized ENKTL. However, concurrent administration of L-asparaginase during CCRT does not seem to provide additional benefits.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
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