Salvage treatment outcome and prognosis of patients with locoregionally recurrent early-stage extranodal NK/T cell lymphoma, nasal type

Objective To retrospectively analyze the prognostic factors for locoregionally recurrent early-stage extranodal nasal-type natural killer/T-cell lymphoma (NKTCL). Methods: A total of 56 patients with early-stage extranodal nasal-type NKTCL, who had locoregional recurrence after initial treatment and then received salvage treatment from 1995 to 2014, were enrolled as subjects. The effects of salvage treatment on the overall survival (OS) rate were analyzed after initial treatment and recurrence. Univariate and multivariate prognostic analyses were performed on the OS rate after recurrence. Results: The median follow-up time was 35.9 months after initial treatment and 14.8 months after recurrence. The 3-year OS rate was 73% after initial treatment and 58% after recurrence. Compared with chemotherapy alone, radiotherapy-containing salvage treatment significantly improved the OS rates after initial treatment and recurrence (P = 0.040, 0.009), and re-irradiation also significantly improved the OS rates after initial treatment and recurrence (P = 0.018, 0.019). Most (84%) of the acute and late adverse reactions after re-irradiation were grade 1-2 ones. The univariate and multivariate analyses showed that the Karnofsky Performance Status score, radiotherapy in initial treatment, and radiotherapy in salvage treatment were influencing factors for the OS rate after recurrence. Conclusions: Radiotherapy achieves improved survival and tolerable toxicities, making it indispensable in the treatment of locoregionally recurrent extranodal nasal-type NKTCL. (authors)