Latest revision as of 12:19, 15 July 2024

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Section editor
	Bhagirathbhai Dholaria, MBBS Vanderbilt University Nashville, TN, USA LinkedIn

Most of these regimens are specific to the nasal type of ENKTCL. For more generic NKTCL regimens, please see this page.

10 regimens on this page 10 variants on this page

Guidelines

Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.

ESMO

2015: d'Amore et al. Peripheral T-cell lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up PubMed

NCCN

NCCN does not currently have guidelines at this granular level; please see NCCN Guidelines - T-cell Lymphomas.

Untreated

Cisplatin & RT

Cisplatin & RT: Cisplatin & Radiation Therapy

Regimen

Study	Dates of enrollment	Evidence	Efficacy
Kim et al. 2009 (CISL 2004-10-08)	2006-04 to 2007-10	Phase 2	ORR: 83%

Chemotherapy

Cisplatin (Platinol) 30 mg/m² IV once per day on days 1, 8, 15, 22

Radiotherapy

Concurrent radiation therapy to the primary tumor, 1.8 to 200 cGy fractions (median total dose: 4000 cGy), given 5 times per week.

4-week course

Subsequent treatment

VIPD consolidation, 3 to 5 weeks after the last dose of cisplatin

References

CISL 2004-10-08: Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. Epub 2009 Nov 2. link to original article dosing details in manuscript have been reviewed by our editors PubMed NCT00418535

DEP & RT

DEP & RT: Dexamethasone, Etoposide, Platinol (Cisplatin), Radiation Therapy

Regimen

Study	Dates of enrollment	Evidence	Efficacy
Tsai et al. 2014 (T1405)	2006-05 to 2009-09	Phase 2	ORR: 81%

Glucocorticoid therapy

Dexamethasone (Decadron) 20 mg/m²/day IV on days 1 to 3

Chemotherapy

Etoposide (Vepesid) 75 mg/m² IV over 60 minutes once per day on days 1 to 3
Cisplatin (Platinol) 75 mg/m² IV over 4 hours once on day 1

Radiotherapy

Concurrent radiation therapy to the primary tumor: 5040 cGy in 28 fractions

28-day cycle for 2 cycles

Subsequent treatment

VIPD consolidation

References

T1405: Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. link to original article contains dosing details on CT.gov PubMed NCT00292695

DeVIC & RT

DeVIC & RT: Dexamethasone, VP-16 (Etoposide), Ifosfamide, Carboplatin, Radiation Therapy

Regimen

Study	Dates of enrollment	Evidence	Efficacy
Yamaguchi et al. 2009 (JCOG0211)	2003-09 to 2006-12	Phase 1/2	ORR: 81%

Note: this is the recommended dose level used in the phase 2 portion.

Glucocorticoid therapy

Dexamethasone (Decadron) 40 mg IV once per day on days 1 to 3

Chemotherapy

Etoposide (Vepesid) 67 mg/m² IV over 2 hours once per day on days 1 to 3, 22 to 24, 43 to 45
Ifosfamide (Ifex) 1000 mg/m² IV over 3 hours once per day on days 1 to 3, 22 to 24, 43 to 45
Carboplatin (Paraplatin) 200 mg/m² IV over 30 minutes once per day on days 1, 22, 43

Supportive therapy

Filgrastim (Neupogen) (dose/route/schedule not specified) started for WBC count less than 2 x 10⁹/L or ANC less than 1000/μL; discontinued if WBC count more than 5 x 10⁹/L

Radiotherapy

Started simultaneously with the beginning of cycle 1 of chemotherapy

Concurrent radiation therapy by the following stage-based criteria:
- Stage IE: 200 cGy fractions x 25 fractions (total dose: 5000 cGy)
- Stage IIE: 180 cGy fractions x 28 fractions (total dose: 5040 cGy)

9-week course

References

JCOG0211: Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Ohshima K, Matsuno Y, Terauchi T, Nawano S, Ishikura S, Kagami Y, Hotta T, Oshimi K. Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol. 2009 Nov 20;27(33):5594-600. Epub 2009 Oct 5. link to original article dosing details in manuscript have been reviewed by our editors PubMed
1. Update: Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Hotta T, Tsukasaki K, Oshimi K. Concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: an updated analysis of the Japan clinical oncology group study JCOG0211. J Clin Oncol. 2012 Nov 10;30(32):4044-6. Epub 2012 Oct 8. link to original article PubMed

GELOX/RT

GELOX/RT: Gemcitabine, L-asparaginase, Oxaliplatin, alternating with Radiation Therapy

Study	Dates of enrollment	Evidence	Efficacy
Wang et al. 2012	2008-01 to 2011-07	Phase 2	ORR: 96%

Note: total number of chemotherapy cycles was limited to 6.

Induction

Chemotherapy

Gemcitabine (Gemzar) 1000 mg/m² IV once per day on days 1 & 8
Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 7
Oxaliplatin (Eloxatin) 130 mg/m² IV once on day 1

21-day cycle for at least 2 cycles, followed by:

Definitive therapy

Radiotherapy

IFRT to 5600 cGy in 28 fractions, 5 fractions per week

5.5-week course, followed within one week by:

Consolidation

Chemotherapy

Gemcitabine (Gemzar) 1000 mg/m² IV once per day on days 1 & 8
Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 7
Oxaliplatin (Eloxatin) 130 mg/m² IV once on day 1

21-day cycle for up to 4 cycles

References

Wang L, Wang ZH, Chen XQ, Li YJ, Wang KF, Xia YF, Xia ZJ. First-line combination of gemcitabine, oxaliplatin, and L-asparaginase (GELOX) followed by involved-field radiation therapy for patients with stage IE/IIE extranodal natural killer/T-cell lymphoma. Cancer. 2013 Jan 15;119(2):348-55. Epub 2012 Jul 18. link to original article dosing details in manuscript have been reviewed by our editors PubMed

LVP "Sandwich"

LVP: L-asparaginase, Vincristine, Prednisolone

Study	Dates of enrollment	Evidence	Efficacy
Jiang et al. 2011	2008-07 to 2009-11	Phase 2	ORR: 84%

Induction

Chemotherapy

Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 5
Vincristine (Oncovin) 1.4 mg/m² IV once on day 1

Glucocorticoid therapy

Prednisolone (Millipred) 100 mg PO once per day on days 1 to 5

21-day cycle for 2 cycles, followed by:

Definitive therapy

Radiotherapy

External beam radiotherapy to the nasal cavity and surrounding sinuses, 5600 cGy in 28 fractions, once per day, five days per week

5.5-week course, followed in one week by:

Consolidation

Chemotherapy

Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 5
Vincristine (Oncovin) 1.4 mg/m² IV once on day 1

Glucocorticoid therapy

Prednisolone (Millipred) 100 mg PO once per day on days 1 to 5

21-day cycle for up to 4 cycles

References

Jiang M, Zhang H, Jiang Y, Yang Q, Xie L, Liu W, Zhang W, Ji X, Li P, Chen N, Zhao S, Wang F, Zou L. Phase 2 trial of "sandwich" L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer. 2012 Jul 1;118(13):3294-301. Epub 2011 Dec 2. link to original article dosing details in manuscript have been reviewed by our editors PubMed ChicTR-TNC-00000394

MESA/RT

MESA/RT: Methotrexate, Etoposide, Steroid (dexamethasone), PEG-A-sparaginase alternating with Radiation Ttherapy

Study	Dates of enrollment	Evidence	Efficacy
Liang et al. 2016 (MESA-NKT2013)	2012-12 to 2015-01	Phase 2	ORR: 87%

Induction

Chemotherapy

Methotrexate (MTX) 2000 mg/m² IV once on day 1
Etoposide (Vepesid) 100 mg/m² IV once per day on days 2 to 4
Pegaspargase (Oncaspar) 2500 IU/m² IM once on day 5

Glucocorticoid therapy

Dexamethasone (Decadron) 20 mg/m² IV once per day on days 2 to 5

21-day cycle for at least 3 cycles, followed by:

Definitive therapy

Radiotherapy

Radiation therapy, 45 to 5000 cGy in 25 fractions

One course, followed by:

Consolidation

Chemotherapy

Methotrexate (MTX) 2000 mg/m² IV once on day 1
Etoposide (Vepesid) 100 mg/m² IV once per day on days 2 to 4
Pegaspargase (Oncaspar) 2500 IU/m² IM once on day 5

Glucocorticoid therapy

Dexamethasone (Decadron) 20 mg/m² IV once per day on days 2 to 5

21-day cycle for a maximum of 7 cycles

References

MESA-NKT2013: Liang R, Gao GX, Chen JP, Wang JS, Wang XM, Zeng Y, Bai QX, Zhang T, Yang L, Dong BX, Gu HT, Shu MM, Hao CX, Wang JH, Zhang N, Chen XQ. A phase 2 study of methotrexate, etoposide, dexamethasone, and pegaspargase chemotherapy for newly diagnosed, relapsed, or refractory extranodal natural killer/T-cell lymphoma, nasal type: a multicenter trial in Northwest China. Hematol Oncol. 2017 Dec;35(4):619-629. Epub 2016 Oct 10. link to original article link to PMC article dosing details in manuscript have been reviewed by our editors PubMed

SMILE

SMILE: Steroid (Dexamethasone), Methotrexate, Ifosfamide, L-asparaginase, Etoposide

Regimen

Study	Dates of enrollment	Evidence	Efficacy
Yamaguchi et al. 2011	2007-07 to 2009-10	Phase 2	ORR: 79%

Note: After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.

Glucocorticoid therapy

Dexamethasone (Decadron) 40 mg IV or PO once per day on days 2 to 4

Chemotherapy

Methotrexate (MTX) 2000 mg/m² IV over 6 hours once on day 1
Ifosfamide (Ifex) 1500 mg/m² IV once per day on days 2 to 4
Asparaginase (Elspar) 6000 units/m² IV once per day on days 8, 10, 12, 14, 16, 18, 20
Etoposide (Vepesid) 100 mg/m² IV once per day on days 2 to 4

Supportive therapy

Leucovorin (Folinic acid) 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of methotrexate
Mesna (Mesnex) 300 mg/m² IV three times per day on days 2 to 4; first dose given together with ifosfamide, second dose given at 4 hours after start of ifosfamide, and third dose given 8 hours after start of ifosfamide
Filgrastim (Neupogen) (dose not specified) IV or SC once per day, starting on day 6, given until WBC count more than 5 x 10⁹/L
Trimethoprim-Sulfamethoxazole (Bactrim DS) prophylaxis recommended

28-day cycle for 2 cycles (see note)

References

Phase 1: Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article PubMed content property of HemOnc.org
Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. link to original article dosing details in manuscript have been reviewed by our editors PubMed UMIN000000712

Consolidation after upfront therapy

VIPD

VIPD: VP-16 (Etoposide), Ifosfamide, Platinol (Cisplatin), Dexamethasone

Regimen

Study	Dates of enrollment	Evidence
Kim et al. 2009 (CISL 2004-10-08)	2006-04 to 2007-10	Phase 2
Tsai et al. 2014 (T1405)	2006-05 to 2009-09	Phase 2

Details here are from CISL 2004-10-08.

Preceding treatment

CISL 2004-10-08: Cisplatin & RT induction
T1405: DEP & RT induction

Chemotherapy

Etoposide (Vepesid) 100 mg/m² IV over 90 minutes once per day on days 1 to 3
Ifosfamide (Ifex) 1200 mg/m² IV over 60 minutes once per day on days 1 to 3
Cisplatin (Platinol) 33 mg/m² IV over 60 minutes once per day on days 1 to 3

Glucocorticoid therapy

Dexamethasone (Decadron) 40 mg IV or PO once per day on days 1 to 4

Supportive therapy

Mesna (Mesnex) 240 mg/m² IV over 15 minutes once per day on days 1 to 3
G-CSF given for grade 3 or 4 neutropenia

21-day cycle for up to 3 cycles

References

CISL 2004-10-08: Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. Epub 2009 Nov 2. link to original article dosing details in manuscript have been reviewed by our editors PubMed NCT00418535
T1405: Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. link to original article PubMed NCT00292695

Relapsed or refractory

L-Asparaginase, Vincristine, Prednisolone

LVP: L-asparaginase, Vincristine, Prednisolone

Regimen

Study	Dates of enrollment	Evidence	Efficacy
Yong et al. 2003	1992-03 to 2002-03	Phase 2, fewer than 20 patients	ORR: 83%

Note: Regimen details are from a review article; original article is not available through PubMed

Chemotherapy

Asparaginase (Elspar) 6000 units/m² IV once per day on days 1 to 5
Vincristine (Oncovin) 1.4 mg/m² IV once on day 1

Glucocorticoid therapy

Prednisolone (Millipred) 100 mg PO once per day on days 1 to 5

References

Yong W, Zheng W, Zhang Y, Zhu J, Wei Y, Zhu D, Li J. L-asparaginase-based regimen in the treatment of refractory midline nasal/nasal-type T/NK-cell lymphoma. Int J Hematol. 2003 Aug;78(2):163-7. link to original article PubMed

SMILE

SMILE: Steroid (Dexamethasone), Methotrexate, Ifosfamide, L-asparaginase, Etoposide

Regimen

Study	Dates of enrollment	Evidence	Efficacy
Yamaguchi et al. 2011	2007-07 to 2009-10	Phase 2	ORR: 79%

Note: After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.

Glucocorticoid therapy

Dexamethasone (Decadron) 40 mg IV or PO once per day on days 2 to 4

Chemotherapy

Methotrexate (MTX) 2000 mg/m² IV over 6 hours once on day 1
Ifosfamide (Ifex) 1500 mg/m² IV once per day on days 2 to 4
Asparaginase (Elspar) 6000 units/m² IV once per day on days 8, 10, 12, 14, 16, 18, 20
Etoposide (Vepesid) 100 mg/m² IV once per day on days 2 to 4

Supportive therapy

Leucovorin (Folinic acid) 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of methotrexate
Mesna (Mesnex) 300 mg/m² IV three times per day on days 2 to 4; first dose given together with Ifosfamide (Ifex), second dose given at 4 hours after start of ifosfamide, and third dose given 8 hours after start of ifosfamide
Filgrastim (Neupogen) (dose not specified) IV or SC once per day, starting on day 6, given until WBC count more than 5 x 10⁹/L
Trimethoprim-Sulfamethoxazole (Bactrim DS) prophylaxis recommended

28-day cycle for 2 cycles (see note)

References

Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. link to original article dosing details in manuscript have been reviewed by our editors PubMed

@@ Line 3: / Line 3: @@
 [[#top|Back to Top]]
 </div>
-{| class="wikitable" style="text-align:center; width:50%;"
+{{#lst:Editorial board transclusions|tcl}}
-!colspan="2" align="center" style="color:white; font-size:125%; background-color:#de2d26"|'''Section editor'''
+'''Most of these regimens are specific to the nasal type of ENKTCL. For more generic NKTCL regimens, please see [[NK- and T-cell lymphoma|this page]].'''
-|-
-|style="background-color:#F0F0F0"|[[File:Bdholaria.jpg|frameless|upright=0.3|center]]
-|<big>[[User:Bdholaria|Bhagirathbhai Dholaria, MBBS]]<br>Vanderbilt University<br>Nashville, TN</big>
-|-
-|}
 {| class="wikitable" style="float:right; margin-right: 5px;"
 |-
-|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
+|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
-<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
+<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 |}
 {{TOC limit|limit=3}}
 =Guidelines=
-==[http://www.esmo.org/ ESMO]==
+'''Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.'''
-*'''2015:''' d'Amore et al. [https://www.esmo.org/Guidelines/Haematological-Malignancies/Peripheral-T-Cell-Lymphomas Peripheral T-cell lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up]
+==[https://www.esmo.org/ ESMO]==
-=="How I Treat"==
+*'''2015:''' d'Amore et al. [https://www.esmo.org/Guidelines/Haematological-Malignancies/Peripheral-T-Cell-Lymphomas Peripheral T-cell lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up] [https://pubmed.ncbi.nlm.nih.gov/26314772 PubMed]
-* Tse E, Kwong YL. How I treat NK/T-cell lymphomas. Blood. 2013 Jun 20;121(25):4997-5005. Epub 2013 May 7. [http://www.bloodjournal.org/content/121/25/4997.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/23652805 PubMed]
+==NCCN==
-==[https://www.nccn.org/ NCCN]==
+*''NCCN does not currently have guidelines at this granular level; please see [https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1483 NCCN Guidelines - T-cell Lymphomas].''
-*[https://www.nccn.org/professionals/physician_gls/pdf/t-cell.pdf NCCN Guidelines - T-cell Lymphomas]
 =Untreated=
 ==Cisplatin & RT {{#subobject:544d0b|Regimen=1}}==
 Cisplatin & RT: Cisplatin & '''<u>R</u>'''adiation '''<u>T</u>'''herapy
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:550baf|Variant=1}}===
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
 |[https://doi.org/10.1200/jco.2009.23.8592 Kim et al. 2009 (CISL 2004-10-08)]
+|2006-04 to 2007-10
 |style="background-color:#91cf61"|Phase 2
 | style="background-color:#e0ecf4" |ORR: 83%
 |-
 |}
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
 *[[Cisplatin (Platinol)]] 30 mg/m<sup>2</sup> IV once per day on days 1, 8, 15, 22
 ====Radiotherapy====
-*Concurrent [[External_beam_radiotherapy|radiation therapy]] to the primary tumor, 1.8 to 2 Gy fractions (median total dose: 40 Gy), given 5 times per week.
+*Concurrent [[External_beam_radiotherapy|radiation therapy]] to the primary tumor, 1.8 to 200 cGy fractions (median total dose: 4000 cGy), given 5 times per week.
 '''4-week course'''
+</div>
+<div class="toccolours" style="background-color:#cbd5e7">
 ====Subsequent treatment====
-*[[#VIPD|VIPD consolidation]], 3 to 5 weeks after the last dose of cisplatin
+*[[#VIPD|VIPD]] consolidation, 3 to 5 weeks after the last dose of cisplatin
+</div></div>
 ===References===
-#'''CISL 2004-10-08:''' Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed,  stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. [https://doi.org/10.1200/jco.2009.23.8592 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19884539 PubMed] NCT00418535
+#'''CISL 2004-10-08:''' Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. Epub 2009 Nov 2. [https://doi.org/10.1200/jco.2009.23.8592 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/19884539/ PubMed] [https://clinicaltrials.gov/study/NCT00418535 NCT00418535]
 ==DEP & RT {{#subobject:d8a9eb|Regimen=1}}==
 DEP & RT: '''<u>D</u>'''examethasone, '''<u>E</u>'''toposide, '''<u>P</u>'''latinol (Cisplatin), '''<u>R</u>'''adiation '''<u>T</u>'''herapy
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:f93f37|Variant=1}}===
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
 |[https://doi.org/10.1111/ejh.12405 Tsai et al. 2014 (T1405)]
+|2006-05 to 2009-09
 |style="background-color:#91cf61"|Phase 2
 | style="background-color:#e0ecf4" |ORR: 81%
 |-
 |}
-''Dosing details not available in the abstract.''
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Glucocorticoid therapy====
-*[[Dexamethasone (Decadron)]]
+*[[Dexamethasone (Decadron)]] 20 mg/m<sup>2</sup>/day IV on days 1 to 3
 ====Chemotherapy====
-*[[Etoposide (Vepesid)]]
+*[[Etoposide (Vepesid)]] 75 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 3
-*[[Cisplatin (Platinol)]]
+*[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV over 4 hours once on day 1
+====Radiotherapy====
+*Concurrent [[External_beam_radiotherapy|radiation therapy]] to the primary tumor: 5040 cGy in 28 fractions
 '''28-day cycle for 2 cycles'''
-====Radiotherapy====
+</div>
-*Concurrent [[External_beam_radiotherapy|radiation therapy]] to the primary tumor, 50.4 Gy in 28 fractions
+<div class="toccolours" style="background-color:#cbd5e7">
-'''5.5-week course'''
 ====Subsequent treatment====
-*[[#VIPD|VIPD consolidation]]
+*[[#VIPD|VIPD]] consolidation
+</div></div>
 ===References===
-#'''T1405:''' Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. [https://doi.org/10.1111/ejh.12405 link to original article] [https://pubmed.ncbi.nlm.nih.gov/24957163 PubMed] NCT00292695
+#'''T1405:''' Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. [https://doi.org/10.1111/ejh.12405 link to original article] '''contains dosing details on CT.gov''' [https://pubmed.ncbi.nlm.nih.gov/24957163/ PubMed] [https://clinicaltrials.gov/study/NCT00292695 NCT00292695]
 ==DeVIC & RT {{#subobject:4b25e6|Regimen=1}}==
 DeVIC & RT: '''<u>De</u>'''xamethasone, '''<u>V</u>'''P-16 (Etoposide), '''<u>I</u>'''fosfamide, '''<u>C</u>'''arboplatin, '''<u>R</u>'''adiation '''<u>T</u>'''herapy
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:74ecfd|Variant=1}}===
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
 |[https://doi.org/10.1200/jco.2009.23.8295 Yamaguchi et al. 2009 (JCOG0211)]
-|style="background-color:#91cf61"|Phase 2
+|2003-09 to 2006-12
+|style="background-color:#91cf61"|Phase 1/2
 | style="background-color:#e0ecf4" |ORR: 81%
 |-
 |}
+''Note: this is the recommended dose level used in the phase 2 portion.''
-====Glucocorticoid therapy, Dose Level I====
+<div class="toccolours" style="background-color:#b3e2cd">
+====Glucocorticoid therapy====
 *[[Dexamethasone (Decadron)]] 40 mg IV once per day on days 1 to 3
-====Chemotherapy, Dose Level I====
+====Chemotherapy====
-*[[Etoposide (Vepesid)]] 67 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3
+*[[Etoposide (Vepesid)]] 67 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3, 22 to 24, 43 to 45
-*[[Ifosfamide (Ifex)]] 1000 mg/m<sup>2</sup> IV over 3 hours once per day on days 1 to 3
+*[[Ifosfamide (Ifex)]] 1000 mg/m<sup>2</sup> IV over 3 hours once per day on days 1 to 3, 22 to 24, 43 to 45
-*[[Carboplatin (Paraplatin)]] 200 mg/m<sup>2</sup> IV over 30 minutes once on day 1
+*[[Carboplatin (Paraplatin)]] 200 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1, 22, 43
+====Supportive therapy====
-====Glucocorticoid therapy, Dose Level II====
+*[[Filgrastim (Neupogen)]] (dose/route/schedule not specified) started for WBC count less than 2 x 10<sup>9</sup>/L or ANC less than 1000/μL; discontinued if WBC count more than 5 x 10<sup>9</sup>/L
-*[[Dexamethasone (Decadron)]] 40 mg IV once per day on days 1 to 3
-====Chemotherapy, Dose Level II====
-*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3
-*[[Ifosfamide (Ifex)]] 1500 mg/m<sup>2</sup> IV over 3 hours once per day on days 1 to 3
-*[[Carboplatin (Paraplatin)]] 300 mg/m<sup>2</sup> IV over 30 minutes once on day 1
-====Supportive medications====
-*[[Filgrastim (Neupogen)]] (dose/route/schedule not specified) started for WBC count less than 2 x 10<sup>9</sup>/L or ANC less than 1000/uL; discontinued if WBC count greater than 5 x 10<sup>9</sup>/L.
-'''21-day cycle for 3 cycles'''
 ====Radiotherapy====
 ''Started simultaneously with the beginning of cycle 1 of chemotherapy''
 *Concurrent [[External_beam_radiotherapy|radiation therapy]] by the following stage-based criteria:
-**Stage IE disease: 2 Gy fractions x 25 fractions (total dose: 50 Gy)
+**Stage IE: 200 cGy fractions x 25 fractions (total dose: 5000 cGy)
-**Stage IIE disease: 1.8 Gy fractions x 28 fractions (total dose: 50.4 Gy)
+**Stage IIE: 180 cGy fractions x 28 fractions (total dose: 5040 cGy)
-'''5- to 6-week course'''
+'''9-week course'''
+</div></div>
 ===References===
-# '''JCOG0211:''' Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Ohshima K, Matsuno Y, Terauchi T, Nawano S, Ishikura S, Kagami Y, Hotta T, Oshimi K. Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol. 2009 Nov 20;27(33):5594-600. [https://doi.org/10.1200/jco.2009.23.8295 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19805668 PubMed]
+# '''JCOG0211:''' Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Ohshima K, Matsuno Y, Terauchi T, Nawano S, Ishikura S, Kagami Y, Hotta T, Oshimi K. Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol. 2009 Nov 20;27(33):5594-600. Epub 2009 Oct 5. [https://doi.org/10.1200/jco.2009.23.8295 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/19805668/ PubMed]
-## '''Update:''' Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Hotta T, Tsukasaki K, Oshimi K. Concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: an updated analysis of the Japan clinical oncology group study JCOG0211. J Clin Oncol. 2012 Nov 10;30(32):4044-6. Epub 2012 Oct 8. [https://doi.org/10.1200/jco.2012.45.6541 link to original article] [https://pubmed.ncbi.nlm.nih.gov/23045573 PubMed]
+## '''Update:''' Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y, Ishizawa K, Maseki N, Itoh K, Usui N, Wasada I, Kinoshita T, Hotta T, Tsukasaki K, Oshimi K. Concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: an updated analysis of the Japan clinical oncology group study JCOG0211. J Clin Oncol. 2012 Nov 10;30(32):4044-6. Epub 2012 Oct 8. [https://doi.org/10.1200/jco.2012.45.6541 link to original article] [https://pubmed.ncbi.nlm.nih.gov/23045573/ PubMed]
 ==GELOX/RT {{#subobject:e51517|Regimen=1}}==
 GELOX/RT: '''<u>G</u>'''emcitabine, '''<u>L</u>'''-asparaginase, '''<u>O</u>'''xaliplatin, alternating with '''<u>R</u>'''adiation '''<u>T</u>'''herapy
-===Protocol {{#subobject:ed4bb8|Variant=1}}===
+<div class="toccolours" style="background-color:#c8a2c8">
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
 |[https://doi.org/10.1002/cncr.27752 Wang et al. 2012]
+|2008-01 to 2011-07
 |style="background-color:#91cf61"|Phase 2
 | style="background-color:#f7fcfd" |ORR: 96%
@@ Line 144: / Line 135: @@
 |}
 ''Note: total number of chemotherapy cycles was limited to 6.''
-====Chemotherapy, part 1====
+<div class="toccolours" style="background-color:#eeeeee">
+===Induction {{#subobject:ed4bb8|Variant=1}}===
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
 *[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 8
 *[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 7
 *[[Oxaliplatin (Eloxatin)]] 130 mg/m<sup>2</sup> IV once on day 1
 '''21-day cycle for at least 2 cycles, followed by:'''
+</div></div><br>
+<div class="toccolours" style="background-color:#eeeeee">
+===Definitive therapy===
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Radiotherapy====
-*[[External_beam_radiotherapy|IFRT]] to 56 Gy in 28 fractions, 5 fractions per week
+*[[External_beam_radiotherapy|IFRT]] to 5600 cGy in 28 fractions, 5 fractions per week
 '''5.5-week course, followed within one week by:'''
-====Chemotherapy, part 2====
+</div></div><br>
+<div class="toccolours" style="background-color:#eeeeee">
+===Consolidation===
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
 *[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 8
 *[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 7
 *[[Oxaliplatin (Eloxatin)]] 130 mg/m<sup>2</sup> IV once on day 1
 '''21-day cycle for up to 4 cycles'''
+</div></div></div>
 ===References===
-# Wang L, Wang ZH, Chen XQ, Li YJ, Wang KF, Xia YF, Xia ZJ. First-line combination of gemcitabine, oxaliplatin, and L-asparaginase (GELOX) followed by involved-field radiation therapy for patients with stage IE/IIE extranodal natural killer/T-cell lymphoma. Cancer. 2013 Jan 15;119(2):348-55. Epub 2012 Jul 18. [https://doi.org/10.1002/cncr.27752 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22811078 PubMed]
+# Wang L, Wang ZH, Chen XQ, Li YJ, Wang KF, Xia YF, Xia ZJ. First-line combination of gemcitabine, oxaliplatin, and L-asparaginase (GELOX) followed by involved-field radiation therapy for patients with stage IE/IIE extranodal natural killer/T-cell lymphoma. Cancer. 2013 Jan 15;119(2):348-55. Epub 2012 Jul 18. [https://doi.org/10.1002/cncr.27752 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/22811078/ PubMed]
 ==LVP "Sandwich" {{#subobject:b50432|Regimen=1}}==
 LVP: '''<u>L</u>'''-asparaginase, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisolone
-===Protocol {{#subobject:5a27c1|Variant=1}}===
+<div class="toccolours" style="background-color:#c8a2c8">
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
 |[https://doi.org/10.1002/cncr.26629 Jiang et al. 2011]
+|2008-07 to 2009-11
 |style="background-color:#91cf61"|Phase 2
 | style="background-color:#e0ecf4" |ORR: 84%
 |-
 |}
-====Chemotherapy, part 1====
+<div class="toccolours" style="background-color:#eeeeee">
+===Induction {{#subobject:5a27c1|Variant=1}}===
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
 *[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 5
 *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once on day 1
-====Glucocorticoid therapy, part 1====
+====Glucocorticoid therapy====
 *[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 5
 '''21-day cycle for 2 cycles, followed by:'''
+</div></div><br>
+<div class="toccolours" style="background-color:#eeeeee">
+===Definitive therapy===
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Radiotherapy====
-*[[External beam radiotherapy]] to the nasal cavity and surrounding sinuses, 56 Gy in 28 fractions, once per day, five days per week
+*[[External beam radiotherapy]] to the nasal cavity and surrounding sinuses, 5600 cGy in 28 fractions, once per day, five days per week
 '''5.5-week course, followed in one week by:'''
-====Chemotherapy, part 2====
+</div></div><br>
+<div class="toccolours" style="background-color:#eeeeee">
+===Consolidation===
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
 *[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 5
 *[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once on day 1
-====Glucocorticoid therapy, part 2====
+====Glucocorticoid therapy====
 *[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 5
 '''21-day cycle for up to 4 cycles'''
+</div></div></div>
 ===References===
-# Jiang M, Zhang H, Jiang Y, Yang Q, Xie L, Liu W, Zhang W, Ji X, Li P, Chen N, Zhao S, Wang F, Zou L. Phase 2 trial of "sandwich" L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer. 2012 Jul 1;118(13):3294-301. Epub 2011 Dec 2. [https://doi.org/10.1002/cncr.26629 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22139825 PubMed]
+# Jiang M, Zhang H, Jiang Y, Yang Q, Xie L, Liu W, Zhang W, Ji X, Li P, Chen N, Zhao S, Wang F, Zou L. Phase 2 trial of "sandwich" L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer. 2012 Jul 1;118(13):3294-301. Epub 2011 Dec 2. [https://doi.org/10.1002/cncr.26629 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/22139825/ PubMed] ChicTR-TNC-00000394
 ==MESA/RT {{#subobject:54b89d|Regimen=1}}==
 MESA/RT: '''<u>M</u>'''ethotrexate, '''<u>E</u>'''toposide, '''<u>S</u>'''teroid (dexamethasone), PEG-'''<u>A</u>'''-sparaginase alternating with '''<u>R</u>'''adiation '''<u>T</u>'''therapy
-===Protocol {{#subobject:f98dcf|Variant=1}}===
+<div class="toccolours" style="background-color:#c8a2c8">
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
-|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763273/ Liang et al. 2016]
+|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763273/ Liang et al. 2016 (MESA-NKT2013)]
+|2012-12 to 2015-01
 |style="background-color:#91cf61"|Phase 2
 |style="background-color:#e0ecf4"|ORR: 87%
 |-
 |}
-''Note: this regimen also incorporates radiation, see text for details.''
+<div class="toccolours" style="background-color:#eeeeee">
-====Chemotherapy, part 1====
+===Induction {{#subobject:f98dcf|Variant=1}}===
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
 *[[Methotrexate (MTX)]] 2000 mg/m<sup>2</sup> IV once on day 1
 *[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 2 to 4
 *[[Pegaspargase (Oncaspar)]] 2500 IU/m<sup>2</sup> IM once on day 5
-====Glucocorticoid therapy, part 1====
+====Glucocorticoid therapy====
 *[[Dexamethasone (Decadron)]] 20 mg/m<sup>2</sup> IV once per day on days 2 to 5
 '''21-day cycle for at least 3 cycles, followed by:'''
+</div></div><br>
+<div class="toccolours" style="background-color:#eeeeee">
+===Definitive therapy===
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Radiotherapy====
-*[[External_beam_radiotherapy|Radiation therapy]], 45 to 50 Gy in 25 fractions
+*[[External_beam_radiotherapy|Radiation therapy]], 45 to 5000 cGy in 25 fractions
 '''One course, followed by:'''
-====Chemotherapy, part 2====
+</div></div><br>
+<div class="toccolours" style="background-color:#eeeeee">
+===Consolidation===
+<div class="toccolours" style="background-color:#b3e2cd">
+====Chemotherapy====
 *[[Methotrexate (MTX)]] 2000 mg/m<sup>2</sup> IV once on day 1
 *[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 2 to 4
 *[[Pegaspargase (Oncaspar)]] 2500 IU/m<sup>2</sup> IM once on day 5
-====Glucocorticoid therapy, part 1====
+====Glucocorticoid therapy====
 *[[Dexamethasone (Decadron)]] 20 mg/m<sup>2</sup> IV once per day on days 2 to 5
 '''21-day cycle for a maximum of 7 cycles'''
+</div></div></div>
 ===References===
-# Liang R, Gao GX, Chen JP, Wang JS, Wang XM, Zeng Y, Bai QX, Zhang T, Yang L, Dong BX, Gu HT, Shu MM, Hao CX, Wang JH, Zhang N, Chen XQ. A phase 2 study of methotrexate, etoposide, dexamethasone, and pegaspargase chemotherapy for newly diagnosed, relapsed, or refractory extranodal natural killer/T-cell lymphoma, nasal type: a multicenter trial in Northwest China. Hematol Oncol. 2017 Dec;35(4):619-629. Epub 2016 Oct 10. [https://doi.org/10.1002/hon.2325 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763273/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/27723108 PubMed]
+# '''MESA-NKT2013:''' Liang R, Gao GX, Chen JP, Wang JS, Wang XM, Zeng Y, Bai QX, Zhang T, Yang L, Dong BX, Gu HT, Shu MM, Hao CX, Wang JH, Zhang N, Chen XQ. A phase 2 study of methotrexate, etoposide, dexamethasone, and pegaspargase chemotherapy for newly diagnosed, relapsed, or refractory extranodal natural killer/T-cell lymphoma, nasal type: a multicenter trial in Northwest China. Hematol Oncol. 2017 Dec;35(4):619-629. Epub 2016 Oct 10. [https://doi.org/10.1002/hon.2325 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763273/ link to PMC article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/27723108/ PubMed]
 ==SMILE {{#subobject:eaf2e1|Regimen=1}}==
 SMILE: '''<u>S</u>'''teroid (Dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:cfe666|Variant=1}}===
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
 |[https://doi.org/10.1200/jco.2011.35.6287 Yamaguchi et al. 2011]
+|2007-07 to 2009-10
 |style="background-color:#91cf61"|Phase 2
 |style="background-color:#e0ecf4"|ORR: 79%
 |-
 |}
+''Note: After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.''
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Glucocorticoid therapy====
 *[[Dexamethasone (Decadron)]] 40 mg IV or PO once per day on days 2 to 4
@@ Line 256: / Line 278: @@
 *[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 8, 10, 12, 14, 16, 18, 20
 *[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 2 to 4
+====Supportive therapy====
-====Supportive medications====
+*[[Leucovorin (Folinic acid)]] 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of methotrexate
-*[[Folinic acid (Leucovorin)]] 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of [[Methotrexate (MTX)]]
+*[[Mesna (Mesnex)]] 300 mg/m<sup>2</sup> IV three times per day on days 2 to 4; first dose given together with ifosfamide, second dose given at 4 hours after start of ifosfamide, and third dose given 8 hours after start of ifosfamide
-*[[Mesna (Mesnex)]] 300 mg/m<sup>2</sup> IV three times per day on days 2 to 4; first dose given together with [[Ifosfamide (Ifex)]], second dose given at 4 hours after start of [[Ifosfamide (Ifex)]], and third dose given 8 hours after start of [[Ifosfamide (Ifex)]]
+*[[Filgrastim (Neupogen)]] (dose not specified) IV or SC once per day, starting on day 6, given until WBC count more than 5 x 10<sup>9</sup>/L
-*[[Filgrastim (Neupogen)]] (dose not specified) IV or SC once per day, starting on day 6, given until WBC count greater than 5 x 10<sup>9</sup>/L
 *[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] prophylaxis recommended
+'''28-day cycle for 2 cycles (see note)'''
-'''28-day cycle for 2 cycles'''
+</div></div>
-''After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.''
 ===References===
-# '''Phase 1:''' Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [https://doi.org/10.1111/j.1349-7006.2008.00768.x link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/18294294 PubMed] content property of [http://hemonc.org HemOnc.org]
+# '''Phase 1:''' Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [https://doi.org/10.1111/j.1349-7006.2008.00768.x link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11158592/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18294294/ PubMed] content property of [https://hemonc.org HemOnc.org]
-# Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. [https://doi.org/10.1200/jco.2011.35.6287 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21990393 PubMed]
+# Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. [https://doi.org/10.1200/jco.2011.35.6287 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/21990393/ PubMed] UMIN000000712
 =Consolidation after upfront therapy=
 ==VIPD {{#subobject:1de775|Regimen=1}}==
 VIPD: '''<u>V</u>'''P-16 (Etoposide), '''<u>I</u>'''fosfamide, '''<u>P</u>'''latinol (Cisplatin), '''<u>D</u>'''examethasone
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:76171b|Variant=1}}===
-{| class="wikitable" style="width: 40%; text-align:center;"
+{| class="wikitable sortable" style="width: 60%; text-align:center;"
-!style="width: 25%"|Study
+!style="width: 33%"|Study
-!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 33%"|Dates of enrollment
+!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 |-
 |[https://doi.org/10.1200/jco.2009.23.8592 Kim et al. 2009 (CISL 2004-10-08)]
+|2006-04 to 2007-10
 |style="background-color:#91cf61"|Phase 2
 |-
 |[https://doi.org/10.1111/ejh.12405 Tsai et al. 2014 (T1405)]
+|2006-05 to 2009-09
 |style="background-color:#91cf61"|Phase 2
 |-
 |}
 ''Details here are from CISL 2004-10-08.''
+<div class="toccolours" style="background-color:#cbd5e8">
 ====Preceding treatment====
-*'''CISL 2004-10-08:''' [[#Cisplatin_.26_RT|Cisplatin & concurrent RT]]
+*CISL 2004-10-08: [[#Cisplatin_.26_RT|Cisplatin & RT]] induction
-*'''T1405:''' [[#DEP_.26_RT|DEP & concurrent RT]]
+*T1405: [[#DEP_.26_RT|DEP & RT]] induction
+</div>
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
 *[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV over 90 minutes once per day on days 1 to 3
@@ Line 298: / Line 321: @@
 ====Glucocorticoid therapy====
 *[[Dexamethasone (Decadron)]] 40 mg IV or PO once per day on days 1 to 4
+====Supportive therapy====
-====Supportive medications====
 *[[Mesna (Mesnex)]] 240 mg/m<sup>2</sup> IV over 15 minutes once per day on days 1 to 3
 *[[:Category:Granulocyte colony-stimulating factors|G-CSF]] given for grade 3 or 4 neutropenia
 '''21-day cycle for up to 3 cycles'''
+</div></div>
 ===References===
-# '''CISL 2004-10-08:''' Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed,  stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. [https://doi.org/10.1200/jco.2009.23.8592 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19884539 PubMed] NCT00418535
+# '''CISL 2004-10-08:''' Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J, Lee SW, Kim JS, Cho J, Lee GW, Kang KM, Eom HS, Pyo HR, Ahn YC, Ko YH, Kim WS; Consortium for Improving Survival of Lymphoma. Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-Cell Lymphoma: Consortium for Improving Survival of Lymphoma study. J Clin Oncol. 2009 Dec 10;27(35):6027-32. Epub 2009 Nov 2. [https://doi.org/10.1200/jco.2009.23.8592 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/19884539/ PubMed] [https://clinicaltrials.gov/study/NCT00418535 NCT00418535]
-#'''T1405:''' Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. [https://doi.org/10.1111/ejh.12405 link to original article] [https://pubmed.ncbi.nlm.nih.gov/24957163 PubMed] NCT00292695
+#'''T1405:''' Tsai HJ, Lin SF, Chen CC, Chen TY, Su WC, Hwang WL, Lin JC, Chiou TJ, Kao WY, Chiu CF, Chang YF, Chang JS, Chang MC, Su IJ. Long-term results of a phase II trial with frontline concurrent chemoradiotherapy followed by consolidation chemotherapy for localized nasal natural killer/T-cell lymphoma. Eur J Haematol. 2015 Feb;94(2):130-7. Epub 2014 Oct 10. [https://doi.org/10.1111/ejh.12405 link to original article] [https://pubmed.ncbi.nlm.nih.gov/24957163/ PubMed] [https://clinicaltrials.gov/study/NCT00292695 NCT00292695]
 =Relapsed or refractory=
-==AspaMetDex {{#subobject:407753|Regimen=1}}==
-AspaMetDex: '''<u>Aspa</u>'''raginase, '''<u>Met</u>'''hotrexate, '''<u>Dex</u>'''amethasone
-===Regimen {{#subobject:305a48|Variant=1}}===
-{| class="wikitable" style="width: 60%; text-align:center;"
-!style="width: 33%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
-|-
-|[http://www.bloodjournal.org/content/117/6/1834.long Jaccard et al. 2011 (I05009)]
-|style="background-color:#91cf61"|Phase 2
-| style="background-color:#e0ecf4" |ORR: 78%
-|-
-|}
-====Chemotherapy====
-*[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IM once per day on days 2, 4, 6, 8
-*[[Methotrexate (MTX)]] by the following age-based criteria:
-**Age up to 70: 3000 mg/m<sup>2</sup> (route not specified) once on day 1
-**Older than 70: 2000 mg/m<sup>2</sup> (route not specified) once on day 1
-====Glucocorticoid therapy====
-*[[Dexamethasone (Decadron)]] by the following age-based criteria:
-**Age up to 70: 40 mg PO once per day on days 1 to 4
-**Older than 70: 20 mg PO once per day on days 1 to 4
-====Supportive medications====
-*[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] (dose/route/schedule not specified) prophylaxis, discontinued during [[Methotrexate (MTX)]] administration
-*[[Valacyclovir (Valtrex)]] (dose/route/schedule not specified) prophylaxis
-*For [[Methotrexate (MTX)]]: alkaline hydration and [[Folinic acid (Leucovorin)]] rescue (dose/route/schedule not specified)
-'''21-day cycle for 3 cycles'''
-====Subsequent treatment====
-*See paper for details about further treatment
-===References===
-# '''I05009:''' Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, Tilly H, Morschhauser F, Thieblemont C, Ysebaert L, Devidas A, Petit B, de Leval L, Gaulard P, Feuillard J, Bordessoule D, Hermine O; GELA; GOELAMS. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. [http://www.bloodjournal.org/content/117/6/1834.long link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21123825 PubMed] NCT00283985
-==AspaMetDex (Erwinaze) {{#subobject:402253|Regimen=1}}==
-AspaMetDex: '''<u>Aspa</u>'''raginase, '''<u>Met</u>'''hotrexate, '''<u>Dex</u>'''amethasone
-===Regimen {{#subobject:308gy8|Variant=1}}===
-{| class="wikitable" style="width: 60%; text-align:center;"
-!style="width: 33%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
-|-
-|[http://www.bloodjournal.org/content/117/6/1834.long Jaccard et al. 2011 (I05009)]
-|style="background-color:#91cf61"|Phase 2
-| style="background-color:#e0ecf4" |ORR: 78%
-|-
-|}
-''Note: this regimen is for patients with allergies to asparaginase.''
-====Chemotherapy====
-*[[Asparaginase Erwinia chrysanthemi (Erwinaze)]] 20,000 units/m<sup>2</sup> IM once per day on days 2, 4, 6, 8
-*[[Methotrexate (MTX)]] by the following age-based criteria:
-**Age up to 70: 3000 mg/m<sup>2</sup> (route not specified) once on day 1
-**Older than 70: 2000 mg/m<sup>2</sup> (route not specified) once on day 1
-====Glucocorticoid therapy====
-*[[Dexamethasone (Decadron)]] by the following age-based criteria:
-**Age up to 70: 40 mg PO once per day on days 1 to 4
-**Older than 70: 20 mg PO once per day on days 1 to 4
-====Supportive medications====
-*[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] (dose/route/schedule not specified) prophylaxis, discontinued during [[Methotrexate (MTX)]] administration
-*[[Valacyclovir (Valtrex)]] (dose/route/schedule not specified) prophylaxis
-*For [[Methotrexate (MTX)]]: alkaline hydration and [[Folinic acid (Leucovorin)]] rescue (dose/route/schedule not specified)
-'''21-day cycle for 3 cycles'''
-====Subsequent treatment====
-*See paper for details about further treatment
-===References===
-# '''I05009:''' Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F, Tilly H, Morschhauser F, Thieblemont C, Ysebaert L, Devidas A, Petit B, de Leval L, Gaulard P, Feuillard J, Bordessoule D, Hermine O; GELA; GOELAMS. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood. 2011 Feb 10;117(6):1834-9. [http://www.bloodjournal.org/content/117/6/1834.long link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21123825 PubMed] NCT00283985
 ==L-Asparaginase, Vincristine, Prednisolone {{#subobject:1ba9b6|Regimen=1}}==
 LVP: '''<u>L</u>'''-asparaginase, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisolone
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:651a7|Variant=1}}===
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
 |[https://doi.org/10.1007/bf02983387 Yong et al. 2003]
-|style="background-color:#ffffbe"|Phase 2, <20 patients
+|1992-03 to 2002-03
+|style="background-color:#ffffbe"|Phase 2, fewer than 20 patients
 | style="background-color:#e0ecf4" |ORR: 83%
 |-
 |}
-''Regimen details are from a review article; original article is not available through PubMed''
+''Note: Regimen details are from a review article; original article is not available through PubMed''
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Chemotherapy====
 *[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 1 to 5
@@ Line 407: / Line 354: @@
 ====Glucocorticoid therapy====
 *[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 5
+</div></div>
 ===References===
-# Yong W, Zheng W, Zhang Y, Zhu J, Wei Y, Zhu D, Li J. L-asparaginase-based regimen in the treatment of refractory midline nasal/nasal-type T/NK-cell lymphoma. Int J Hematol. 2003 Aug;78(2):163-7. [https://doi.org/10.1007/bf02983387 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12953813 PubMed]
+# Yong W, Zheng W, Zhang Y, Zhu J, Wei Y, Zhu D, Li J. L-asparaginase-based regimen in the treatment of refractory midline nasal/nasal-type T/NK-cell lymphoma. Int J Hematol. 2003 Aug;78(2):163-7. [https://doi.org/10.1007/bf02983387 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12953813/ PubMed]
 ==SMILE {{#subobject:924b1a|Regimen=1}}==
 SMILE: '''<u>S</u>'''teroid (Dexamethasone), '''<u>M</u>'''ethotrexate, '''<u>I</u>'''fosfamide, '''<u>L</u>'''-asparaginase, '''<u>E</u>'''toposide
+<div class="toccolours" style="background-color:#eeeeee">
 ===Regimen {{#subobject:aa2ac|Variant=1}}===
-{| class="wikitable" style="width: 60%; text-align:center;"
+{| class="wikitable sortable" style="width: 80%; text-align:center;"
-!style="width: 33%"|Study
+!style="width: 25%"|Study
-!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|Dates of enrollment
-!style="width: 33%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
+!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 |-
 |[https://doi.org/10.1200/jco.2011.35.6287 Yamaguchi et al. 2011]
+|2007-07 to 2009-10
 |style="background-color:#91cf61"|Phase 2
 | style="background-color:#e0ecf4" |ORR: 79%
 |-
 |}
+''Note: After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.''
+<div class="toccolours" style="background-color:#b3e2cd">
 ====Glucocorticoid therapy====
 *[[Dexamethasone (Decadron)]] 40 mg IV or PO once per day on days 2 to 4
@@ Line 432: / Line 382: @@
 *[[Asparaginase (Elspar)]] 6000 units/m<sup>2</sup> IV once per day on days 8, 10, 12, 14, 16, 18, 20
 *[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 2 to 4
+====Supportive therapy====
-====Supportive medications====
+*[[Leucovorin (Folinic acid)]] 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of methotrexate
-*[[Folinic acid (Leucovorin)]] 15 mg IV or PO every 6 hours on days 2 to 4, beginning 30 hours after completion of [[Methotrexate (MTX)]]
+*[[Mesna (Mesnex)]] 300 mg/m<sup>2</sup> IV three times per day on days 2 to 4; first dose given together with [[Ifosfamide (Ifex)]], second dose given at 4 hours after start of ifosfamide, and third dose given 8 hours after start of ifosfamide
-*[[Mesna (Mesnex)]] 300 mg/m<sup>2</sup> IV three times per day on days 2 to 4; first dose given together with [[Ifosfamide (Ifex)]], second dose given at 4 hours after start of [[Ifosfamide (Ifex)]], and third dose given 8 hours after start of [[Ifosfamide (Ifex)]]
+*[[Filgrastim (Neupogen)]] (dose not specified) IV or SC once per day, starting on day 6, given until WBC count more than 5 x 10<sup>9</sup>/L
-*[[Filgrastim (Neupogen)]] (dose not specified) IV or SC once per day, starting on day 6, given until WBC count greater than 5 x 10<sup>9</sup>/L
 *[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] prophylaxis recommended
+'''28-day cycle for 2 cycles (see note)'''
-'''28-day cycle for 2 cycles'''
+</div></div>
-''After 2 cycles, patients could receive additional treatment with SMILE and/or other chemotherapy, with or without autologous/allogeneic stem cell transplant.''
 ===References===
-# '''Phase 1:''' Yamaguchi M, Suzuki R, Kwong YL, Kim WS, Hasegawa Y, Izutsu K, Suzumiya J, Okamura T, Nakamura S, Kawa K, Oshimi K. Phase I study of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia. Cancer Sci. 2008 May;99(5):1016-20. Epub 2008 Feb 19. [https://doi.org/10.1111/j.1349-7006.2008.00768.x link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/18294294 PubMed] content property of [http://hemonc.org HemOnc.org]
+# Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. [https://doi.org/10.1200/jco.2011.35.6287 link to original article] '''dosing details in manuscript have been reviewed by our editors''' [https://pubmed.ncbi.nlm.nih.gov/21990393/ PubMed]
-# Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C, Izutsu K, Ishida F, Isobe Y, Sueoka E, Suzumiya J, Kodama T, Kimura H, Hyo R, Nakamura S, Oshimi K, Suzuki R; NK-Cell Tumor Study Group. Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol. 2011 Nov 20;29(33):4410-6. Epub 2011 Oct 11. [https://doi.org/10.1200/jco.2011.35.6287 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21990393 PubMed]
 [[Category:Extranodal NK- and T-cell lymphoma, nasal type regimens]]
 [[Category:Disease-specific pages]]
 [[Category:T-cell lymphomas]]

Difference between revisions of "Extranodal NK- and T-cell lymphoma, nasal type"

Latest revision as of 12:19, 15 July 2024

Guidelines

ESMO

NCCN

Untreated

Cisplatin & RT

Regimen

Chemotherapy

Radiotherapy

Subsequent treatment

References

DEP & RT

Regimen

Glucocorticoid therapy

Chemotherapy

Radiotherapy

Subsequent treatment

References

DeVIC & RT

Regimen

Glucocorticoid therapy

Chemotherapy

Supportive therapy

Radiotherapy

References

GELOX/RT

Induction

Chemotherapy

Definitive therapy

Radiotherapy

Consolidation

Chemotherapy

References

LVP "Sandwich"

Induction

Chemotherapy

Glucocorticoid therapy

Definitive therapy

Radiotherapy

Consolidation

Chemotherapy

Glucocorticoid therapy

References

MESA/RT

Induction

Chemotherapy

Glucocorticoid therapy

Definitive therapy

Radiotherapy

Consolidation

Chemotherapy

Glucocorticoid therapy

References

SMILE

Regimen

Glucocorticoid therapy

Chemotherapy

Supportive therapy

References

Consolidation after upfront therapy

VIPD

Regimen

Preceding treatment

Chemotherapy

Glucocorticoid therapy

Supportive therapy

References

Relapsed or refractory

L-Asparaginase, Vincristine, Prednisolone

Regimen

Chemotherapy

Glucocorticoid therapy

References

SMILE

Regimen

Glucocorticoid therapy

Chemotherapy

Supportive therapy

References