{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:18:59Z","timestamp":1787570339143,"version":"build-2736575974"},"reference-count":51,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Clinical Medical Scientist Training Program under the \u2018Three 100s\u2032 Initiative of Henan Province","award":["HNCMS202428"],"award-info":[{"award-number":["HNCMS202428"]}]},{"name":"Outstanding Youth Item of Henan Health-related Technological and Innovative Talents Project","award":["11459"],"award-info":[{"award-number":["11459"]}]},{"name":"Henan Medical Science and Technology Tacking Program","award":["LHJG20190021"],"award-info":[{"award-number":["LHJG20190021"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optimizing chemotherapy for elderly patients with extranodal natural killer\/T-cell lymphoma (ENKTL) represents a significant clinical challenge, requiring a balance between effective relative dose intensity (RDI) and treatment tolerance. The prognostic impact of RDI in this population remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the relationship between RDI and survival outcomes and to establish a clinically meaningful RDI threshold for elderly ENKTL patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective observational single-center cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study analyzed treatment-na\u00efve ENKTL patients aged \u226560 years who received DDGP-like regimens or P-GEMOX regimen between May 2016 and December 2023. The optimal RDI cutoff was determined by receiver operating characteristic curve analysis. Variable selection for multivariable Cox regression was performed using least absolute shrinkage and selection operator (LASSO) regression to mitigate overfitting and adjust for potential confounders. The primary endpoints were progression-free survival (PFS) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 79 patients were enrolled. The median number of chemotherapy cycles was 3 (IQR: 3-5), with a median treatment interval of 26 days (IQR: 23\u201331). Treatment delays exceeding one week occurred in 55.7% of patients (n = 44), and only 2.5% (n = 2) received full dose intensity (RDI = 1). An average RDI \u2265 0.62 was significantly associated with prolonged PFS (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.010) and OS (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.012). Multivariable analysis confirmed higher RDI as an independent predictor of superior PFS (HR = 0.385, 95% CI: 0.186-0.801,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.011) and OS (HR = 0.433, 95% CI: 0.194-0.968,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.041). Furthermore, age\u226570 years (vs.60-70 years; p = 0.007), diabetes (p = 0.039), and adverse events including infection (p = 0.033), rash (p = 0.043), and diarrhea (p = 0.017) were significant predictors of reduced RDI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An ARDI \u2265 0.62 may represent a critical threshold associated with improved prognosis in elderly ENKTL. However, this observation is preliminary and warrants further validation in prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20406207261480376","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T15:01:47Z","timestamp":1787324507000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of chemotherapy relative dose intensity on survival in elderly patients with extranodal NK\/T-cell lymphoma: A retrospective cohort study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8778-2163","authenticated-orcid":false,"given":"Wanyue","family":"Zhao","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Qian","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiao","family":"Chang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Gu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuchang","family":"Li","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shifeng","family":"Hao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Gao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou 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