Extranodal NK-T-cell lymphoma medical therapy: Difference between revisions

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{{CMG}}; {{AE}} {{AS}}
{{CMG}}; {{AE}} {{AS}}
==Overview==
==Overview==
The predominant therapy for extranodal NK-T-cell lymphoma is [[radiation therapy]]. Adjunctive [[chemotherapy]] and [[stem cell transplant]] may be required.<ref name= canadiancancer>Extranodal NK/T-cell lymphoma, nasal type. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/extranodal-nk-t-cell-lymphoma-nasal-type/?region=on. Accessed on February 02, 2016 </ref>
The predominant therapy for extranodal NK-T-cell lymphoma is [[radiation therapy]]. Adjunctive [[chemotherapy]] and [[stem cell transplant]] may be required.
==Medical Therapy==
==Medical Therapy==
The predominant therapy for extranodal NK-T-cell lymphoma is [[radiation therapy]]. Adjunctive [[chemotherapy]] and [[stem cell transplant]] may be required.


{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
* The predominant therapy for extranodal NK-T-cell lymphoma is [[radiation therapy]]. Adjunctive [[chemotherapy]] and [[stem cell transplant]] may be required.<ref name="canadiancancer" />
|+ '''Treatment of extranodal NK-T-cell lymphoma<ref name= canadiancancer>Extranodal NK/T-cell lymphoma, nasal type. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/extranodal-nk-t-cell-lymphoma-nasal-type/?region=on. Accessed on February 02, 2016 </ref>'''
* Therapy of extranodal NK/T cell lymphoma depends on staging of the tumor:<ref name="DreylingThieblemont2013">{{cite journal|last1=Dreyling|first1=M.|last2=Thieblemont|first2=C.|last3=Gallamini|first3=A.|last4=Arcaini|first4=L.|last5=Campo|first5=E.|last6=Hermine|first6=O.|last7=Kluin-Nelemans|first7=J. C.|last8=Ladetto|first8=M.|last9=Le Gouill|first9=S.|last10=Iannitto|first10=E.|last11=Pileri|first11=S.|last12=Rodriguez|first12=J.|last13=Schmitz|first13=N.|last14=Wotherspoon|first14=A.|last15=Zinzani|first15=P.|last16=Zucca|first16=E.|title=ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma|journal=Annals of Oncology|volume=24|issue=4|year=2013|pages=857–877|issn=1569-8041|doi=10.1093/annonc/mds643}}</ref><ref name="IsobeUno2006">{{cite journal|last1=Isobe|first1=Koichi|last2=Uno|first2=Takashi|last3=Tamaru|first3=Jun-ichi|last4=Kawakami|first4=Hiroyuki|last5=Ueno|first5=Naoyuki|last6=Wakita|first6=Hisashi|last7=Okada|first7=Jun-ichi|last8=Itami|first8=Jun|last9=Ito|first9=Hisao|title=Extranodal natural killer/T-cell lymphoma, nasal type|journal=Cancer|volume=106|issue=3|year=2006|pages=609–615|issn=0008-543X|doi=10.1002/cncr.21656}}</ref><ref name="LiYao2006">{{cite journal|last1=Li|first1=Ye-Xiong|last2=Yao|first2=Bo|last3=Jin|first3=Jing|last4=Wang|first4=Wei-Hu|last5=Liu|first5=Yue-Ping|last6=Song|first6=Yong-Wen|last7=Wang|first7=Shu-Lian|last8=Liu|first8=Xin-Fan|last9=Zhou|first9=Li-Qiang|last10=He|first10=Xiao-Hui|last11=Lu|first11=Ning|last12=Yu|first12=Zi-Hao|title=Radiotherapy As Primary Treatment for Stage IE and IIE Nasal Natural Killer/T-Cell Lymphoma|journal=Journal of Clinical Oncology|volume=24|issue=1|year=2006|pages=181–189|issn=0732-183X|doi=10.1200/JCO.2005.03.2573}}</ref>
! style="background: #4479BA; color:#FFF;" | Therapy  
 
! style="background: #4479BA; color:#FFF;" | Description  
{| class="wikitable"
|+'''Favored treatment of extranodal NK/T cell lymphoma''' based on staging
!Stage
!Involvment
!Common involvement place
!Preferred therapy method
!Radiation dosage
!Chemotherapy regimen
!Alternative
|-
|I(E)
|Single extranodal involvement
|upper aerodigestive tract
|Combined modality therapy‡
|50 Gy RT
|DeVIC∞
|
|-
|II(E)
|Stage I(E) +One or more of  † involvments
|upper aerodigestive tract
|
|
|
|
|-
|III(E)•
|Stage I (E) + Cervical lymph node involvment + infradiaphragmatic lymph node / Involvment of spleen
|Systemic
|
|
|
|
|-
|IV
|Stage I(E) +isolated distant involvment
|Systemic
|
|
|
|
|}
†: Cervical lymph node involvement / Involvment of other superdiaphragmatic lymph node regions / Isolated involvment of additional sites in the head and neck
 
•: Rare
 
‡: Combined modality therapy is radiation therapy with concurrent chemotherapy
 
∞:Dexamethasone, Etoposide, Ifosfamide, Carboplatin.
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+'''Treatment of extranodal NK-T-cell lymphoma<ref name="canadiancancer">Extranodal NK/T-cell lymphoma, nasal type. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/extranodal-nk-t-cell-lymphoma-nasal-type/?region=on. Accessed on February 02, 2016 </ref>'''
! style="background: #4479BA; color:#FFF;" | Therapy
! style="background: #4479BA; color:#FFF;" | Description
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" | Radiation therapy
| style="padding: 5px 5px; background: #DCDCDC;" | Radiation therapy
Line 20: Line 71:
* Chemotherapy is often added to radiation therapy to treat extranodal NK/T-cell lymphoma
* Chemotherapy is often added to radiation therapy to treat extranodal NK/T-cell lymphoma
* If extranodal NK-T-cell lymphoma is more widespread, then [[chemotherapy]] may be more intense and higher doses may be used
* If extranodal NK-T-cell lymphoma is more widespread, then [[chemotherapy]] may be more intense and higher doses may be used
* Drug regimen: (CHOP) [[Cyclophosphamide]] {{and}} [[Doxorubicin]]  {{and}} [[Vincristine]] {{and}} [[Prednisone]]  
* Drug regimen: (CHOP) [[Cyclophosphamide]] {{and}} [[Doxorubicin]]  {{and}} [[Vincristine]] {{and}} [[Prednisone]]
* CNS Prophylaxis: [[Methotrexate]]
* CNS Prophylaxis: [[Methotrexate]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;" | Stem cell transplant  
| style="padding: 5px 5px; background: #DCDCDC;" | Stem cell transplant
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |  
* May be offered to some people with extranodal NK-T-cell lymphoma who relapse after initial treatment
* May be offered to some people with extranodal NK-T-cell lymphoma who relapse after initial treatment
|}
|}

Revision as of 13:55, 30 August 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

The predominant therapy for extranodal NK-T-cell lymphoma is radiation therapy. Adjunctive chemotherapy and stem cell transplant may be required.

Medical Therapy

Favored treatment of extranodal NK/T cell lymphoma based on staging
Stage Involvment Common involvement place Preferred therapy method Radiation dosage Chemotherapy regimen Alternative
I(E) Single extranodal involvement upper aerodigestive tract Combined modality therapy‡ 50 Gy RT DeVIC∞
II(E) Stage I(E) +One or more of † involvments upper aerodigestive tract
III(E)• Stage I (E) + Cervical lymph node involvment + infradiaphragmatic lymph node / Involvment of spleen Systemic
IV Stage I(E) +isolated distant involvment Systemic

†: Cervical lymph node involvement / Involvment of other superdiaphragmatic lymph node regions / Isolated involvment of additional sites in the head and neck

•: Rare

‡: Combined modality therapy is radiation therapy with concurrent chemotherapy

∞:Dexamethasone, Etoposide, Ifosfamide, Carboplatin.

Treatment of extranodal NK-T-cell lymphoma[1]
Therapy Description
Radiation therapy
Chemotherapy
Stem cell transplant
  • May be offered to some people with extranodal NK-T-cell lymphoma who relapse after initial treatment

References

  1. 1.0 1.1 Extranodal NK/T-cell lymphoma, nasal type. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/extranodal-nk-t-cell-lymphoma-nasal-type/?region=on. Accessed on February 02, 2016
  2. Dreyling, M.; Thieblemont, C.; Gallamini, A.; Arcaini, L.; Campo, E.; Hermine, O.; Kluin-Nelemans, J. C.; Ladetto, M.; Le Gouill, S.; Iannitto, E.; Pileri, S.; Rodriguez, J.; Schmitz, N.; Wotherspoon, A.; Zinzani, P.; Zucca, E. (2013). "ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma". Annals of Oncology. 24 (4): 857–877. doi:10.1093/annonc/mds643. ISSN 1569-8041.
  3. Isobe, Koichi; Uno, Takashi; Tamaru, Jun-ichi; Kawakami, Hiroyuki; Ueno, Naoyuki; Wakita, Hisashi; Okada, Jun-ichi; Itami, Jun; Ito, Hisao (2006). "Extranodal natural killer/T-cell lymphoma, nasal type". Cancer. 106 (3): 609–615. doi:10.1002/cncr.21656. ISSN 0008-543X.
  4. Li, Ye-Xiong; Yao, Bo; Jin, Jing; Wang, Wei-Hu; Liu, Yue-Ping; Song, Yong-Wen; Wang, Shu-Lian; Liu, Xin-Fan; Zhou, Li-Qiang; He, Xiao-Hui; Lu, Ning; Yu, Zi-Hao (2006). "Radiotherapy As Primary Treatment for Stage IE and IIE Nasal Natural Killer/T-Cell Lymphoma". Journal of Clinical Oncology. 24 (1): 181–189. doi:10.1200/JCO.2005.03.2573. ISSN 0732-183X.


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