2004 Volume 30 Issue 4 Pages 533-538
Nasal NK/T-cell lymphoma (N-NKTL) is characterized by progressive unrelenting ulceration and necrosis of the nasal cavity and midline facial tissues. The etiology of the lymphoma is closely associated with Epstein-Barr virus (EBV). Phenotypic finding dual positive for pan-T-cell antigens CD2 and the NK-cell antigen CD56 is important for diagnosis. Recently we found that serum EBV DNA is the most useful tumor marker for diagnosis, disease monitoring and prediction of prognosis in this lymphoma. Previous treatment with systemic chemotherapy followed by radiotherapy was not an effective method, with median survival of only 6 months. Recently, we performed radiochemotherapy including local irradiation with total dose of 56 Gy along with concomitant intra-maxillary arterial infusion of chemotherapy reagents. For concomitant radiochemotherapy, we planned a new regimen of MPVIC-P (VP-16 100 mg/m2 on days 1 and 15, ifosfamide (IFM) 1500 mg/m2 on days 1 and 15, carboplatin (CBDCA) 100 mg/m2 on days 8 and 22, methotrexate 325 mg/m2 with leucovorin rescue on day 8, peplomycin 10 mg/m2 on day 22, and predonisolone 75 mg/body first 3 days on the week) was employed in 3 cycles. We treated 4 patients with concomitant radiochemotherapy, and all of them were alive and tumor free.
