Risk-adapted therapy for early-stage extranodal nasal-type NK/ XXXX : analysis from a multicenter study.

@entity1 @entity5 @entity784 @entity880 @entity7730 @entity1349
UNASSIGNED: The optimal combination and sequence of radiotherapy (RT) and @entity7730 ( @entity7730 ) for extranodal nasal-type natural killer/ @entity784 (NKTCL) are not well-defined. The aim of this study was to create a risk-adapted therapeutic strategy for early-stage NKTCL. A total of 1273 early-stage @entity1 from 10 institutions were reviewed. @entity1 received @entity7730 alone (n = 170), RT alone (n = 253), RT followed by @entity7730 (n = 209), or @entity7730 followed by RT (n = 641). A comprehensive comparative study was performed using multivariable and propensity score-matched analyses. Early-stage NKTCL was classified as low risk or high risk based on 5 independent prognostic factors (stage, age, performance status, @entity880 dehydrogenase, primary @entity5 invasion). RT alone and RT with or without @entity7730 were more effective than @entity7730 alone (5-year @entity1349 [ @entity1349 ], 69.6% and 67.7% vs 33.9%, P < .001). For low-risk @entity1 , RT alone achieved a favorable @entity1349 (88.8%); incorporation of induction or consolidation @entity7730 did not provide additional benefit (86.9% and 86.3%). For high-risk @entity1 , RT followed by @entity7730 resulted in superior @entity1349 (72.2%) compared with induction @entity7730 and RT (58.3%, P = .004) or RT alone (59.6%, P = .017). After adjustment, similar significant differences in @entity1349 were still observed between treatment groups. New @entity7730 regimens provided limited benefit in early-stage NKTCL. Risk-adapted therapy involving RT alone for low-risk @entity1 and RT consolidated by @entity7730 for high-risk @entity1 is a viable, effective strategy for early-stage NKTCL.
