ABCL-193: Insights into Diagnosis and Treatment of Nasopharyngeal Non-Hodgkin Lymphomas

Abstract

Context Non-Hodgkin lymphomas (NHL) are heterogeneous lymphoproliferative tumors with different disease burdens (DB) and responses to treatment. Objective Identification of the diagnosis patterns and assessment of the short-term results of treatment in primary nasopharyngeal NHL. Design This analytical and cohort study included 66 patients with nasopharyngeal NHL who were managed at the Institute of Oncology from Moldova between 2014–2020. The diagnosis was proved by cytological, histopathological, and immunohistochemical examinations. Setting The patients’ follow-up and study were performed at the comprehensive cancer center. Patients The patients age ranged between 19–86 years (average age: 58.4±2,14 years). Stage I was diagnosed in 10 (15.2%) cases, stage II in 36 (54.5%), stage III in 8 (12.1), and stage IV in 12 (18.2). Main Outcomes Measures The ECOG-WHO score and complete response (CR) rate should estimate the short-term results of combined chemotherapy (CChT) and CChT followed by locoregional radiotherapy (LRT). Interventions The eligible patients underwent mostly CVChlP, R-CVChlP, CHOP, and R-CHOP regimens combined with LRT on bulky or residual tumors. Results The aggressive NHL were diagnosed mostly (76.1%) at stage I and II due to the earlier developed DB. The ECOG-WHO score accounted for 1–3. CR was achieved in 10 (100%) stage I cases after CChT and RT. CR occurred in 21 (67.7%) and partial response (PR) in 7 (22.6%) in stage II NHL after CChT and RT. In stage II NHL treated with CChT also, CR was achieved in 1 (25%) and PR in 2 (50%) cases. In stage III treated with CChT and RT, CR was registered in 1 (20%) and PR in 2 (40%) cases. Only PR occurred in 2 (66.7%) stage III cases and 1 (33.3%) stage IV case after CChT alone. In stage IV NHL, CR was obtained in 1 (11.1%) case and PR in 5 (55.6%) after CChT and RT. The ECOG-WHO score reached 0–1 as a result of CChT and RT in cases with CR and PR. Conclusions Aggressive NHLs were diagnosed mostly in localized stages due to the earlier developed DB. Regardless of stage, the highest response rates were achieved after R-CHOP regimen combined with LRT.