Abstract
Initial treatment with radiation alone to doses >54 Gy with has become standard treatment for patients with limited stage extranodal natural killer/T-cell lymphoma, nasal type (NKTL-NT). We report on four consecutive non-Asian patients with NKTLNT treated with IMRT to spare critical structures while delivering high dose to the nasal and paranasal sinuses. Three patients are alive and without evidence of disease at 43.7, 19.5, and 30.4 months following radiation. One patient who died failed locally in an area of modest dose (45-50 Gy) as well as distantly. Acute toxicities were mainly mucositis (3 with Grade 2, 1 with Grade 3) managed with gabapentin and/or narcotics, Grade 2 xerostomia (1 patient), and Grade 1 dermatitis (1 patient).Two patients had late Grade 2 xerostomia and 1 patient required dacryocystorhonostomy for excessive tearing. Early stage NKTL-NT can be treated definitively with high-dose radiation treatment, and we believe that IMRT offers an advantage to improve the therapeutic index over conformal 3-dimensional RT.
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