Treatment Outcome Of Radiotherapy Alone Versus Radiochemotherapy In Early Stage(IE/IIE) Extranodal Nasal-type Natural Killer/T Cell Lymphoma: A Meta-analysis

BackgroundPrevious trails have revealed different findings about the efficacy of radiotherapy(RT) and radiochemotherapy(RCT) in IE/IIE extranodal nasal-type natural killer/T cell lymphoma(ENKTL). RT is regarded as the standard treatment modality, whether the additional CT of RCT is beneficial to IE/IIE ENKTL remains unknown. In this study, a comprehensive meta-analysis was conducted to address this issue.MethodsWe scientifically explored Pub Med, Cochrane Central Register of Controlled Trials(CENTRAL), BISOS, Em Base, Clinical Trials and some Chinese databanks for relevant studies. Through vigilant searching, there were 17 studies which involved 1595 patients encountered our inclusion conditions. ORs(odds ratio) and HRs(hazard ratio) with 95% CIs(confidence intervals) were used to assess the treatment outcomes. ORs were computed for dichotomous variables by applying the Mantel-Haenszel method, while HRs and the 95% CIs were computed using the Engauge Digitizer software and the method of Jayne F Tierney.ResultsThe meta-analysis exhibited no significant variances in complete remission(CR)(OR 0.85, 95%(CI) 0.42-1.72, p = 0.65), 5-year overall survival(OS)(HR 1.11, 95% CI 0.85-1.45, p = 0.43) and 5-year progression free survival(PFS)(HR 1.07, 95% CI 0.75-1.53, p = 0.70) in patients who received RT versus RCT. Furthermore, the addition of CT decreased neither systemic failure(SL)(OR 0.75, 95% CI 0.47-1.21, p = 0.24) nor locoregional failure(LF)(OR 1.17, 95% CI 0.68-2.01, p = 0. 57).ConclusionsCompared with RT, RCT neither prolonged CR, 5-year OS or 5-year PFS nor decreased SF or LF in IE/IIE ENKTL patients. However, our analysis was limited, and high quality studies are needed to identify the best therapy for IE/IIE ENKTL.