Xiaoying Quan,Pinjia Wang,Lei Lei,Xiaoyan Chen,Chunzhi Wu,Bin Ye,Zhihui Zhang. Analysis of clinical efficacy of P-Gemox regimen sandwich radiotherapy, P-Gemox regimen sequential radiotherapy, and radiotherapy alone treatment for extranodal natural killer/T-cell lymphoma. Oncol Transl Med, 2018, 4: 185-195.
Analysis of clinical efficacy of P-Gemox regimen sandwich radiotherapy, P-Gemox regimen sequential radiotherapy, and radiotherapy alone treatment for extranodal natural killer/T-cell lymphoma
Received:September 30, 2018  Revised:November 16, 2018
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KeyWord:pegaspargase; natural killer/T-cell lymphoma; prognosis
Author NameAffiliationE-mail
Xiaoying Quan Department of Medical Oncology, The Sixth People's Hospital of Chengdu, Chengdu 610051, China 1193084163@qq.com 
Pinjia Wang Department of Medical Oncology, The Sixth People's Hospital of Chengdu, Chengdu 610051, China  
Lei Lei Department of Medical Oncology, The Sixth People's Hospital of Chengdu, Chengdu 610051, China  
Xiaoyan Chen Department of Medical Oncology, The Sixth People's Hospital of Chengdu, Chengdu 610051, China  
Chunzhi Wu Department of Medical Oncology, The Sixth People's Hospital of Chengdu, Chengdu 610051, China  
Bin Ye Department of Medical Oncology, The Sixth People's Hospital of Chengdu, Chengdu 610051, China  
Zhihui Zhang Department of Medical Oncology, Sichuan Cancer Hospital and Research Institute, Chengdu 610041, China 13881889731@139.com 
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Abstract:
      Objective The study aimed to explore the clinical efficacy of P-Gemox regimen sandwich radiotherapy, P-Gemox regimen sequential radiotherapy, and radiotherapy alone in early-stage extranodal natural killer/ T-cell lymphoma (ENKTL). Methods In total, 124 patients with early-stage ENKTL, from June 2009 to January 2016, were retrospectively analyzed to compare the clinical efficacy of the three regimens. Results A total of 46 patients were treated with P-Gemox regimen sandwich radiotherapy, with complete remission (CR) of 91.3%, objective response rate (ORR) of 97.8%, 2-year progression-free survival (PFS) of 76.1%, and 2-year overall survival (OS) of 80.4%. Then, 37 patients received P-Gemox regimen sequential radiotherapy, with CR of 86.5%, ORR of 94.6%, 2-year PFS of 75.7%, and 2-year OS of 81.1%. Finally, 41 patients received radiotherapy alone, with CR of 61.0%, ORR of 80.5%, 2-year PFS of 51.2%, and 2-year OS of 65.9%. When the two groups were compared, significant differences in CR, PFS, and OS were observed among the sandwich radiotherapy, sequential radiotherapy, and radiotherapy alone groups (P < 0.05), respectively. However, no significant difference in CR, ORR, PFS, and OS was observed between the sandwich radiotherapy and sequential radiotherapy groups (P > 0.05). Multivariate analysis revealed that Eastern Cooperative Oncology Group (ECOG), serum lactate dehydrogenase (LDH), plateletto-lymphocyte ratio (PLR), local tumor invasion, and treatment modalities were independent prognostic factors for PFS (P < 0.05). ECOG, LDH, PLR, local tumor invasion, underlying disease, and treatment modalities were independent prognostic factors for OS (P < 0.05). Conclusion P-Gemox regimen combination radiotherapy for patients with early-stage ENKTL was better than the radiotherapy alone.
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