Different treatment modalities for patients with early stage extranodal NK/T-cell lymphoma: A retrospective comparative study based on the SEER database / 中华放射医学与防护杂志

ABSTRACT

Objective:To explore the effectiveness of the treatment modality among western localized extranodal NK/T-cell lymphoma (ENKTCL) patients based on the Surveillance, Epidemiology and End Result (SEER) database.Methods:A total of 448 cases of early stage ENKTCL, diagnosed from 2000 to 2016, were identified from the SEER database 108 received chemotherapy alone, 100 received radiation alone, and 240 had combined chemoradiotherapy. Overall survival (OS) were compared between different modalities using univariate, multivariate and propensity-score matched (PSM) method.Results:The median overall survival (OS) and 5-year OS rate were 59.0 months and 49.0% for the whole cohort, respectively. Different treatment modalities were significantly associated with OS of patients with localized ENKTCL. Patients who received chemoradiotherapy had the highest 5-year OS rate followed by those who received radiation alone and chemotherapy alone (62.1% vs. 41.5% vs. 28.5%, χ2=41.727, P<0.001). Patients who received radiation with/without chemotherapy had significant superior survival outcome compared with those who received chemotherapy alone (5-year OS rate, 55.9% vs. 28.5%, χ2=10.823, P<0.001). Furthermore, compared with radiation alone, additional chemother-apy to radiation provided survival benefit and reduced death hazard for localized ENKTCL ( HR 0.578, 95% CI 0.413~0.808, P=0.001). After baseline prognostic factors adjustment using PSM method, similar survival benefit was still observed among patients treated with chemoradiotherapy over those treated with radiation alone (5-year OS, 61.3% vs. 40.5%, HR 0.592, 95% CI 0.369~0.885, P=0.012). Conclusions:These results based on SEER database indicate that compared with radiation or chemotherapy alone, chemoradiotherapy is more preferable treatment option for patients with early stage ENKTCL.