Optimizing the combination of chemotherapeutic drugs along with radiotherapy for extranodal NK/T-cell lymphoma

被引：0

作者：

Luo, Fei ^{[1
,2
]}

Zhong, Qiu-Zi ^{[3
]}

Liu, Xin ^{[1
]}

Hou, Xiao-Rong ^{[4
]}

Qian, Li-Ting ^{[5
]}

Qiao, Xue-Ying ^{[6
]}

Wang, Hua ^{[7
]}

Zhu, Yuan ^{[8
]}

Cao, Jian-Zhong ^{[9
,10
]}

Wu, Jun-Xin ^{[11
]}

Wu, Tao ^{[12
]}

Zhu, Su-Yu ^{[13
,14
]}

Shi, Mei ^{[15
]}

Zhang, Hui-Lai ^{[16
]}

Zhang, Xi-Mei ^{[16
]}

Su, Hang ^{[17
]}

Song, Yu-Qin ^{[18
]}

Zhu, Jun ^{[18
]}

Zhang, Yu-Jing ^{[19
]}

Huang, Hui-Qiang ^{[19
]}

Wang, Ying ^{[20
,21
]}

He, Xia ^{[22
,23
]}

Zhang, Li-Ling ^{[24
]}

Qu, Bao-Lin ^{[25
]}

Yang, Yong ^{[26
]}

Hu, Chen ^{[27
]}

Deng, Min ^{[1
]}

Wang, Shu-Lian ^{[1
]}

Qi, Shu-Nan ^{[1
]}

Li, Ye-Xiong ^{[1
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Dept Radiat Oncol, Natl Canc Ctr,Natl Clin Res Ctr Canc, 17 Panjiayuan Rd, Beijing 100021, Peoples R China

[2] Capital Med Univ, Beijing Shijitan Hosp, Dept Radiat Oncol, Beijing, Peoples R China

[3] Beijing Hosp, Natl Geriatr Med Ctr, Dept Radiat Oncol, Beijing, Peoples R China

[4] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Beijing, Peoples R China

[5] Anhui Med Univ, Affiliated Prov Hosp, Hefei, Anhui, Peoples R China

[6] Hebei Med Univ, Hosp 4, Shijiazhuang, Peoples R China

[7] Second Affiliated Hosp Nanchang Univ, Nanchang, Peoples R China

[8] Chinese Acad Sci, Univ Chinese Acad Sci, Zhejiang Canc Hosp, Inst Canc & Basic Med ,Canc Hosp, Hangzhou, Zhejiang, Peoples R China

[9] Shanxi Med Univ, Shanxi Canc Hosp, Taiyuan, Shanxi, Peoples R China

[10] Shanxi Med Univ, Affiliated Canc Hosp, Taiyuan, Shanxi, Peoples R China

[11] Fujian Prov Canc Hosp, Fuzhou, Fujian, Peoples R China

[12] Guizhou Med Univ, Guizhou Canc Hosp, Affiliated Hosp, Guiyang, Peoples R China

[13] Xiangya Sch Med, Hunan Canc Hosp, Changsha, Hunan, Peoples R China

[14] Xiangya Sch Med, Affiliated Canc Hosp, Changsha, Hunan, Peoples R China

[15] Fourth Mil Med Univ, Xijing Hosp, Xian, Peoples R China

[16] Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Key Lab Canc Prevent & Therapy, Tianjin, Peoples R China

[17] Fifth Med Ctr PLA Gen Hosp, Beijing, Peoples R China

[18] Peking Univ, Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ, Beijing, Peoples R China

[19] Sun Yat sen Univ, Canc Ctr, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China

[20] Chongqing Univ, Canc Hosp, Chongqing, Peoples R China

[21] Chongqing Canc Hosp, Chongqing, Peoples R China

[22] Jiangsu Inst Canc Res, Nanjing, Jiangsu, Peoples R China

[23] Jiangsu Inst Canc Res, Nanjing, Jiangsu, Peoples R China

[24] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Hubei, Peoples R China

[25] Gen Hosp Chinese Peoples Liberat Army, Beijing, Peoples R China

[26] Fujian Med Univ, Union Hosp, Dept Radiat Oncol, Fuzhou, Fujian, Peoples R China

[27] Johns Hopkins Univ, Sidney Kimmel Comprehens Canc Ctr, Sch Med, Div Biostat & Bioinformat, Baltimore, MD USA

来源：

THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY | 2024年 / 16卷

关键词：

combination therapy; drug; NK/T-cell lymphoma; radiotherapy; NASAL-TYPE; RADIATION-THERAPY; GEMCITABINE; SURVIVAL; OUTCOMES; IMMUNOTHERAPY; DEXAMETHASONE; MULTICENTER; CISPLATIN; EFFICACY;

D O I：

暂无

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Extranodal natural killer/T-cell lymphoma (ENKTCL) has a unique treatment principle. However, the optimal combination of drugs along with radiotherapy (RT) is unknown. Design: Retrospective cohort study. Objectives: We screened multiple drug combinations to identify the most efficacious therapeutic combinations. Methods: We reviewed 3105 patients who received 40 chemotherapy regimens with different combinations of 9 drug classes and/or RT. Least absolute shrinkage and selection operator and multivariable Cox regression analyses were used to screen efficacious single drugs and identify optimal combinations for overall survival (OS). Inverse probability of treatment weighting (IPTW) and multivariable analyses were used to compare survival between treatment regimens. Results: Screening and validation revealed RT, asparaginase (ASP), and gemcitabine (GEM) to be the most efficacious single modality/drug. RT remained an important component of first-line treatment, whereas ASP was a fundamental drug of non-anthracycline (ANT)-based regimens. Addition of RT to non-ANT-based or ASP/GEM-based regimens, or addition of an ASP-drug into ANT-based or GEM/platinum-based regimens, improved 5-year OS significantly. Use of ASP/GEM-based regimens was associated with significantly higher 5-year OS (79.9%) compared with ASP/ANT-based (69.2%, p = 0.001), ASP/methotrexate-based (63.5%, p = 0.011), or ASP/not otherwise specified-based (63.2%, p < 0.001) regimens. The survival benefit of ASP/GEM-based regimens over other ASP-based regimens was substantial across risk-stratified and advanced-stage subgroups. The survival benefits of a combination of RT, ASP, and GEM were consistent after adjustment for confounding factors by IPTW. Conclusion: These results suggest that combining ASP/GEM with RT for ENKTCL is an efficacious and feasible therapeutic option and provides a rationale and strategy for developing combination therapies.

引用

页数：16

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