演題抄録

International Symposium

開催概要
開催回
第51回・2013年・京都
 

Genetic features regarding EBV and arterial infusion chemoradiotherapy for NNKTL

演題番号 : IS3-5

[筆頭演者]
Miki Takahara:1 

1:Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Japan

 

Nasal natural killer (NK)/T-cell lymphoma (NNKTL) is a clinical illness characterized by progressive unrelenting ulceration and necrosis of the nasal cavity and midline facial tissues. Since we first demonstrated the presence of Epstein Barr virus (EBV)-DNA in NNKTL, the lymphoma has been classified as one of the EBV-associated malignancies. We previously showed that the NNKTL cells produce interleukin (IL)-9, IL-10, and interferon-γ-inducible protein-10 (IP-10) possibly induced by EBV-oncogenic proteins, and such cytokines enhanced cell proliferation and invasion in an autocrine manner. Furthermore, we have recently shown that environmental inflammatory cells such as monocytes enhance proliferation of the NNKTL cells through IL-15 receptor and CD70.
Even in early clinical stages, NNKTL shows poor prognosis caused by the rapid progression of the lesion into distinct organs. We have been trying arterial infusion chemotherapy from superficial temporal artery in combination with radiotherapy for early stage NNKTL. New regimen for the arterial infusion consists of ifosfamide, carboplatin, methotrexate, peplomycin and etoposide (MPVIC-P). Effect of the treatments was evaluated by serum EBV-DNA copy number quantified by real-time PCR, which has been reported to be very useful tumor marker for NNKTL by the authors. From 2003, 12 patients with early stage NNKTL were treated by the arterial infusion of MPVIC-P regimen for 3 cycles and concomitant radiotherapy of 54-56Gy. All patients achieved complete remission and 3-year disease free survival (DFS) rates were 100%. 10 out of 12 patients had high levels of serum EBV-DNA copy number, however, the levels decreased under detection level after treatment in all patients. According to these results, intra-maxillary arterial chemotherapy with concomitant radiotherapy is effective treatment for early stage NNKTL.

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