Objective To assess the efficacy,safety,and related prognostic factors associated with the P-GemDOx regimen as a first-line treatment for patients with early-stage extranodal natural killer(NK)/T cell lymphoma(ENKTL).Methods A retrospective analysis was performed on sixty early-stage ENKTL patients treated with the P-GemDOx regimen who were admitted to the First Affiliated Hospital of Nanjing Medical University between August 2015 and May 2021.The Chi-square test or Fisher's exact test was used to compare group differences,and the Log-rank test was used to compare the differences in survival.Survival outcomes and prognostic factors were examined.Results After completing 4 to 6 cycles of P-GemDOx chemotherapy,the overall response rate(ORR)was 88.3％,with forty-six patients(76.7％)achieving complete response(CR).The 4-year progression-free survival(PFS)and overall survival(OS)rates were(66.3±7.1)％and(79.5±6.0)％,respectively.According to the PINK/PINK-E model,there was no significant difference in survival outcomes among risk groups.23.3％of patients experienced progression of disease within 24 months(POD＜24).OS estimates differed significantly(P＜0.001)between the POD＜24 group(n=14)and the POD≥24 group(n=46).Analysis showed that SUVmax＞12.8 at diagnosis,non-single nasal cavity infiltration,and response less than CR after 4-6 cycles all had a significant association with POD24.We used these data as the basis for predicting POD＜24 international prognostic index(POD24-IPI).Patients were stratified into low-risk(no risk factors),intermediate-risk(one risk factor),or high risk(two or three risk factors).These groups were associated with 4-year OS rate of 100％,(85.6±9.7)％,and(65.0±10.2)％,respectively(P=0.014).The P-GemDOx regimen was well tolerated,with hematological toxicity being the main side effect.Conclusion This study demonstrated that the P-GemDOx regimen is effective and safe in the first-line treatment of early-stage ENKTL,and POD24-IPI is a promising prognostic model.
NETL
NSTL
维普
万方数据
