Treatment

The optimal therapy for NK/T neoplasms is controversial due to the rarity of these diseases, their variable clinical course, and the lack of randomized clinical trials. As with other lymphomas, surgical resection of sinonasal lymphomas is not recommended. Overall complete remission with different treatment modalities is approximately 65% (39). Initial treatment with radiation therapy (RT) alone might be beneficial to patients with early stage disease, but results from small series are variable (39); the purported advantage of early RT needs to be validated in larger prospective studies. Studies in nasal-type NK/T-cell lymphoma have failed to show outcome improvement with addition of chemotherapy (CT) to RT; moreover, response to CT alone was observed to be poor, with a higher risk of local recurrence. In one study, the five-year overall survival rates for RT alone and RT plus CT were 76% and 59%, respectively (41). Investigators have suggested that CT should be reserved for the control of micrometastasis after achieving local control using RT.

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