Early disease progression in patients with localized natural killer/T-cell lymphoma treated with concurrent chemoradiotherapy

Motoko Yamaguchi, Ritsuro Suzuki, Seok Jin Kim, Young Hyeh Ko, Masahiko Oguchi, Naoko Asano, Kana Miyazaki, Yasuhiko Terui, Nobuko Kubota, Takeshi Maeda, Yukio Kobayashi, Jun Amaki, Toshinori Soejima, Bungo Saito, Emiko Shimoda, Noriko Fukuhara, Norifumi Tsukamoto, Kazuyuki Shimada, Ilseung Choi, Takahiko UtsumiYasuo Ejima, Won Seog Kim, Naoyuki Katayama

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Prognosis of patients with localized nasal extranodal natural killer/T-cell lymphoma, nasal type (ENKL) has been improved by non-anthracycline-containing treatments such as concurrent chemoradiotherapy (CCRT). However, some patients experience early disease progression. To clarify the clinical features and outcomes of these patients, data from 165 patients with localized nasal ENKL who were diagnosed between 2000 and 2013 at 31 institutes in Japan and who received radiotherapy with dexamethasone, etoposide, ifosfamide, and carboplatin (RT-DeVIC) were retrospectively analyzed. Progression of disease within 2 years after diagnosis (POD24) was used as the definition of early progression. An independent dataset of 60 patients with localized nasal ENKL who received CCRT at Samsung Medical Center was used in the validation analysis. POD24 was documented in 23% of patients who received RT-DeVIC and in 25% of patients in the validation cohort. Overall survival (OS) from risk-defining events of the POD24 group was inferior to that of the reference group in both cohorts (P <.00001). In the RT-DeVIC cohort, pretreatment elevated levels of serum soluble interleukin-2 receptor (sIL-2R), lactate dehydrogenase, C-reactive protein, and detectable Epstein-Barr virus DNA in peripheral blood were associated with POD24. In the validation cohort, no pretreatment clinical factor associated with POD24 was identified. Our study indicates that POD24 is a strong indicator of survival in localized ENKL, despite the different CCRT regimens adopted. In the treatment of localized nasal ENKL, POD24 is useful for identifying patients who have unmet medical needs.

Original languageEnglish
Pages (from-to)2056-2062
Number of pages7
JournalCancer Science
Issue number6
Publication statusPublished - 2018 Jun


  • concurrent chemoradiotherapy
  • early progression
  • Epstein-Barr virus
  • NK/T-cell lymphoma
  • soluble interleukin-2 receptor


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