Sequential chemotherapy/radiotherapy was comparable with concurrent chemoradiotherapy for stage I/II NK/T-cell lymphoma

Research output: Contribution to journalArticle


Background: In stage I/II natural killer (NK)/T-cell lymphoma, concurrent chemoradiotherapy (CCRT) had previously been shown to result in superior outcome compared with anthracycline-containing regimens, which have since been considered ineffective. The role of CCRT in comparison with approaches employing nonanthracycline-containing chemotherapy (CT) and sequential radiotherapy (RT) in such patients remains to be defined. Patients and methods: Three hundred and three untreated patients (207 men, 96 women; median age: 51, 18-86 years) with stage I/II NK/T-cell lymphoma who had received nonanthracycline-containing regimens were collected from an international consortium and retrospectively analyzed. Treatment included single modality (CT and RT), sequential modalities (CT+RT; RT+CT) and concurrent modalities (CCRT; CCRT+CT). The impact of clinicopathologic parameters and types of treatment on complete response (CR) rate, progression-free-survival (PFS) and overall-survival (OS) was evaluated. Results: For CR, stage (P=0.027), prognostic index for NK/T-cell lymphoma (PINK) (P=0.026) and types of initial treatment (P=0.011) were significant prognostic factors on multivariate analysis. On Cox regression analysis, ECOG performance score (P=0.021) and PINK-EBV DNA (PINK-E) (P=0.002) significantly impacted on PFS; whereas ECOG performance score (P=0.008) and stage (P<0.001) significantly impacted on OS. For comparing CCRT6CT and sequential CT+RT, CCRT6CT patients (n=190) were similar to sequential CT+RT patients (n=54) in all evaluated clinicopathologic parameters except two significantly superior features (higher proportion of undetectable circulating EBV DNA on diagnosis and lower PINK-E scores). Despite more favorable pre-treatment characteristics, CCRT6CT patients had CR rate, PFS and OS comparable with sequential CT+RT patients on multivariate and Cox regression analyses. Conclusions: In stage I/II NK/T-cell lymphomas, when effective chemotherapeutic regimens were used, CCRT and sequential CT+RT gave similar outcome.


  • Y. L. Kwong
  • S. J. Kim
  • E. Tse
  • S. Y. Oh
  • J. Y. Kwak
  • H. S. Eom
  • Y. R. Do
  • Y. C. Mun
  • S. R. Lee
  • H. J. Shin
  • C. Suh
  • S. S. Chuang
  • Y. S. Lee
  • S. T. Lim
  • K. Izutsu
  • R. Suzuki
  • T. Relander
  • F. d'Amore
  • N. Schmitz
  • A. Jaccard
  • And 1 others
  • W. S. Kim
External organisations
  • Queen Mary Hospital
  • Sungkyunkwan University
  • National Cancer Center, Gyeonggi
  • Ewha Womans University Mokdong Hospital
  • Singapore General Hospital
  • National Cancer Centre Singapore
  • Shimane University
  • Skåne University Hospital
  • Aarhus University Hospital
  • Asklepios Klinik St. Georg
  • University Hospital Of Limoges
  • Dong-a University Hospital
  • Chonbuk National University
  • Keimyung University
  • Korea University Ansan Hospital
  • Pusan National University Yangsan Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology


  • Concurrent chemoradiotherapy, Sequential chemotherapy and radiotherapy, Stage I/II NK/T-cell lymphomas
Original languageEnglish
Article numbermdx684
Pages (from-to)256-263
JournalAnnals of Oncology
Issue number1
Publication statusPublished - 2018 Jan 1
Publication categoryResearch