De-escalating therapy in gastric aggressive lymphoma

Rosanna Cuccurullo, Silvia Govi, Andrés J M Ferreri

Research output: Contribution to journalArticlepeer-review


The treatment of primary gastric diffuse large B-cell lymphoma (DLBCL) has changed radically over the last 10-15 years, with the abandonment of routine gastrectomy in favor of more conservative therapies. Low-level evidence suggests that consolidation radiotherapy could be avoided in patients with limited-stage DLBCL of the stomach who achieve complete remission after rituximab-CHOP combination. Small, recent prospective trials suggest that selected patients with limited-stage Helicobacter pylori (H. pylori)-positive DLBCL of the stomach and favorable prognostic factors can be managed with antibiotics alone, with excellent disease control and cure rates, keeping chemo-radiotherapy for unresponsive patients. This recommendation should equally regard patients with mucosa-associated lymphoid tissue-related or de novo DLBCL. Future studies should be focused on the establishment of reliable variables able to distinguish the best candidates for exclusive treatment with H. pylori eradication from those who need for conventional chemo-immunotherapy.

Original languageEnglish
Pages (from-to)8993-8997
Number of pages5
JournalWorld Journal of Gastroenterology
Issue number27
Publication statusPublished - Jul 21 2014


  • Antibiotic therapy
  • Diffuse large B-cell lymphoma
  • Gastric lymphoma
  • Helicobacter pylori
  • Rituximab

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)


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