First-line gemcitabine, oxaliplatin, and l-asparaginase chemotherapy followed by involved field radiation in stage IE/IIE extranodal NK/T-cell lymphoma.

Abstract

e18540 Background: Now, there is lack of consensus on treatment of Extranodal NK/T cell lymphoma (ENKTL), and no therapy is considered standard. ENKTL shows a poor response to anthracycline-based chemotherapy, such as CHOP or CHOP-like regimens, because of the frequent expression of a multidrug-resistant P-glycoprotein. Thus, we designed an induce chemotherapy regimen consisted of gemcitabine, oxaliplatin and l-asparaginase(GELOX), which are not affected by P-glycoprotein. In addition, we added involved field radiation. The objective of this study is to investigate the efficacy and safety of GELOX followed by involved field radiation. Methods: From January 2008 to April 2010, 17 newly diagnosed patients with stage IE/IIE ENKTL were frontline treated with GELOX chemotherapy (gemcitabine 1000 mg/m2 intravenous drip on day 1,8; oxaliplatin 130mg/m2 intravenous drip on day 1; and l-asparaginase 5000IU/ m2 intravenous drip on days 1-7) followed by involved field radiation ( radiation 46 Gy to 56 Gy) in Sun Yat-sen University Cancer Center. Results: After treatment of GELOX regimen, there were 12 CRs (70.5%, 12/17) and 5 PRs (29.5%, 5/17), which is a 100% response rate. No patient was disease progression or stable during chemotherapy. All patients achieved CRs after involved field radiation, which is a 100% CR rate. At a median follow-up of 18.6 months (range 5–31), 2 (11.8%) of 17 patients experienced disease progression. the estimated median disease-free survival (DFS) is 30.0 months (95% CI, 26.2 to 38.9). Grades 1 to 2 toxicities were frequent during GELOX, but grades 3 to 4 toxicities were rare (5.9%). Conclusions: In conclusion, GELOX followed by involved field radiation can be a feasible and effective treatment strategy for stages IE to IIE ENKTL.