Modern Radiation Therapy for Extranodal Nasal-Type NK/T-cell Lymphoma: Risk-Adapted Therapy, Target Volume, and Dose Guidelines from the International Lymphoma Radiation Oncology Group

Shu Nan Qi, Ye Xiong Li, Lena Specht, Masahiko Oguchi, Richard Tsang, Andrea Ng, Chang Ok Suh, Umberto Ricardi, Michael Mac Manus, Bouthaina Dabaja, Joachim Yahalom

Research output: Contribution to journalReview articlepeer-review

Abstract

In the multidisciplinary management of early-stage extranodal natural killer/T-cell lymphoma, nasal type (ENKTCL), with curative intent, radiation therapy is the most efficacious modality and is an essential component of a combined-modality regimen. In the past decade, utilization of upfront radiation therapy and non–anthracycline-based chemotherapy has improved treatment and prognosis. This guideline mainly addresses the heterogeneity of clinical features, principles of risk-adapted therapy, and the role and appropriate design of radiation therapy. Radiation therapy methods (including target volume definition, dose and delivery methods) are crucial for optimizing cure for patients with early-stage ENKTCL. The application of the principles of involved site radiation therapy in this lymphoma entity often leads to a more extended clinical target volume (CTV) than in other lymphoma types because it usually presents with primary tumor invasion, multifocal lesions, or extensive submucosal infiltration beyond the macroscopic disease. The CTV varies across different primary sites and is classified mainly into nasal, nonnasal upper aerodigestive tract (UADT), and extra-UADT entities. This review is a consensus of the International Lymphoma Radiation Oncology Group regarding the approach to radiation therapy, target-volume definition, optimal dose, and dose constraints in ENKTCL treatment.

Original languageEnglish
Pages (from-to)1064-1081
Number of pages18
JournalInternational Journal of Radiation Oncology Biology Physics
Volume110
Issue number4
DOIs
Publication statusPublished - 2021 Jul 15

Bibliographical note

Funding Information:
Disclosures: L.S. has received (within the last 3 years) honoraria as a member of advisory boards for MSD, This work was supported by grants from the Chinese Academy of Medical Science (CAMS) Innovation Fund for Medical Sciences (CIFMS, 2016-I2M-1-001) and the National Key Projects of Research and Development of China (2016YFC0904600). Takeda, and Kyowa Kirin; honoraria for speaking from Takeda; and research grants from Varian and ViewRay.

Publisher Copyright:
© 2021 Elsevier Inc.

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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