Survival Impact Of Remission Status After Up-front Chemotherapy On The Combined Treatment For Early Extra-node Nasal NK/T Cell Lymphoma

Objective: To investigate the effect of remission status of stage ? and ? nasal NK/T cell lymphoma after asparaginase-based chemotherapy on the survival after comprehensive treatment.Methods: A retrospective analysis was performed on 139 patients with early stage nasal NK/T cell lymphoma treated after induction chemotherapy in hunan tumor hospital from January 2011 to January 2019,including 65 patients receiving chemotherapy +radiotherapy,and 74 patients receiving chemotherapy+radiotherapy+chemotherapy.OS and PFS in each group were statistically analyzed.Survival outcomes were compared between CR and non-cr patients treated with combination therapy.Results: In 139 patients,the 3-year OS and PFS rates of CR group after remission were better than those of non-CR group.The 3-year OS rate was 100% and 80.8%(P=0.014),and the 3-year PFS rate was93% And 74.4%(P=0.04).Preliminary analysis showed that after induction chemotherapy of asparaginase regimens showed better survival benefits than anthracycline regimens,the 3-year OS rate was 87.9% and62.5%(P=0.001),and the 3-year PFS rate was 81.2% And 56.3%(P=0.007).After PSM(Propensity score matching),the OS rate and PFS rate still increased.In 122 cases of comprehensive treatment with asparaginase-based induction chemotherapy,the 3-year OS rate in CR group and non-CR group was 100% and 84.6%(P=0.037);the 3-year PFS rate was 93% and 78.1%(P=0.095).In the asparaginase-based induction chemotherapy + radiotherapy group and chemotherapy +radiotherapy+chemotherapy group,the 3-year OS rate was 89.2% and87.1%(P=0.83),and the 3-year PFS rate was 83.9 and 80.2%(P=0.815).Univariate analysis showed that B symptoms,PTI(primary tumor invasion of peripheral structures),low albumin,anthracycline regimen,and non-CR induction chemotherapy were unfavorable prognostic factors for OS.B symptoms,PTI,anthracycline regimen,and induction chemotherapy were not CR is an adverse prognostic factor of PFS.Multivariate analysis showed that B symptoms,PTI and anthracycline chemotherapy were independent adverse prognostic factors in 139 patients.Conclusion: In the comprehensive treatment with chemotherapy regimen based on asparaginase as the initial treatment,the 3-year efficacy of CR patients after chemotherapy was significantly better than non-CR patients,and the combination of chemotherapy regimen based on asparaginase and radiotherapy is more effective.