医学
内科学
蒽环类
挽救疗法
化疗
B症状
淋巴瘤
肿瘤科
国际预后指标
化疗方案
T细胞淋巴瘤
无进展生存期
外科
胃肠病学
癌症
弥漫性大B细胞淋巴瘤
乳腺癌
作者
Sung Hee Lim,Jung Yong Hong,Soon Thye Lim,Huangming Hong,J. Templeton Arnoud,Weili Zhao,Dok Hyun Yoon,Tiffany Tang,Jaeil Cho,S. Park,Young Hyeh Ko,S. J. Kim,Cheolwon Suh,Tongyu Lin,Won Seog Kim
标识
DOI:10.1093/annonc/mdx316
摘要
Current standard treatment, including non-anthracycline-based chemotherapy and optimal combining of radiotherapy, has dramatically improved outcomes of patients with extranodal natural killer/T-cell lymphoma (ENKTL) during the last decade. This study was conducted to investigate the clinical outcome of ENKTL patients with relapsed or progressive disease after initial current standard therapy.We retrospectively reviewed patients diagnosed with ENKTL at six centers in four countries (China, France, Singapore, and South Korea) from 1997 to 2015 and analyzed 179 patients who had relapsed or progressed after initial current standard therapy.After a median follow-up of 58.6 months (range 27.9-89.2), the median second progression-free survival (PFS) was 4.1 months [95% confidence interval (CI) 3.04-5.16] and overall survival (OS) was 6.4 months (95% CI 4.36-8.51). Multivariate Cox-regression analysis revealed that elevated lactate dehydrogenase, multiple extranodal sites (≥2), and presence of B symptoms were associated with inferior OS (P < 0.05). OS and PFS were significantly different according to both prognostic index of natural killer lymphoma (PINK) and PINK-E (Epstein-Barr virus) models. Salvage chemotherapy with l-asparaginase (l-Asp)-based regimens showed a significantly better clinical benefit to response rate and PFS, although it did not lead to OS improvement. First use of l-Asp in the salvage setting and l-Asp rechallenge at least 6 months after initial treatment were the best candidates for salvage l-Asp containing chemotherapy.Most patients with relapsed or refractory ENKTL had poor prognosis with short survival. Further studies are warranted to determine the optimal treatment of patients with relapsed or refractory ENKTL.
科研通智能强力驱动
Strongly Powered by AbleSci AI