Treatment selection and survival outcomes in Early-Stage peripheral T-Cell lymphomas: does anaplastic lymphoma kinase mutation impact the benefit of consolidative radiotherapy?

Abstract

The role of consolidative radiotherapy (RT) is less substantiated in uncommon peripheral T-cell lymphomas (PTCLs). Anaplastic lymphoma kinase (ALK) mutation sub-categorizes PTCLs, with ALK (+) having a distinctly favorable prognosis. We aimed to use the National Cancer Database to examine the potential role of RT in PTCLs and if ALK mutation can be used to predict the benefit of consolidative RT after multi-agent chemotherapy (combined modality therapy). We identified 3670 stage I–II PTCL patients treated with multi-agent chemotherapy alone or combined modality therapy (CMT) between 1998–2012. After adjusting for immortal-time and indication bias, CMT was associated with better OS than multi-agent chemotherapy alone for ALK (−) patients (HR 0.69, 95% CI 0.52–0.92, p = .01); no significant difference was noted for ALK (+) (HR 1.03, 95% CI 0.75–1.41, p = .85). CMT is associated with improved OS for ALK (−) PTCLs; while no such benefit was seen for the ALK (+) subgroup.

Keywords:

• NCDB
• T-cell lymphoma
• radiotherapy
• ALK

Disclosure statement

Vargo JA serves as pathway director for Lymphoma Clinical Pathways, Elselvier ClinicalPath. Beriwal S serves as director of Clinical Pathways Elsevier ClinicalPath and advisor for Varian. Glaser SM serves as Gynecological Committee Co-chair of Clinical Pathways Elsevier ClinicalPath.

The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology used or the conclusions drawn from these data by the investigators. The interpretation and reporting of these data are the sole responsibility of the authors.

Data availability statement

The data used in the current study were derived from a de-identified National Cancer Data Base file. The authors do not own these data and hence are not permitted to share them in the original form.