TY - JOUR
T1 - Primary mediastinal large B-cell lymphoma (PMLBCL)
T2 - Long-term results from a retrospective multicentre Italian experience in 138 patients treated with CHOP or MACOP-B/VACOP-B
AU - Todeschini, G.
AU - Secchi, S.
AU - Morra, E.
AU - Vitolo, U.
AU - Orlandi, E.
AU - Pasini, F.
AU - Gallo, E.
AU - Ambrosetti, A.
AU - Tecchio, C.
AU - Tarella, C.
AU - Gabbas, A.
AU - Gallamini, A.
AU - Gargantini, L.
AU - Pizzuti, M.
AU - Fioritoni, G.
AU - Gottin, L.
AU - Rossi, G.
AU - Lazzarino, M.
AU - Menestrina, F.
AU - Paulli, M.
AU - Palestro, M.
AU - Cabras, M. G.
AU - Di Vito, F.
AU - Pizzolo, G.
PY - 2004/1/26
Y1 - 2004/1/26
N2 - The optimal treatment of primary mediastinal large B-cell lymphoma (PMLBCL) is still undefined. In the absence of randomised studies, we retrospectively analysed: (a) the effectiveness of two chemotherapy regimens (CHOP vs MACOP-B/VACOP-B) in complete remission (CR) achievement and event-free survival (EFS) and (b) the role of mediastinal involved-field radiotherapy (IF-RT) as consolidation. From 1982 to 1999, 138 consecutive patients affected by PMLBCL were treated in 13 Italian institutions with CHOP (43) or MACOP-B/VACOP-B (95), The two groups of patients were similar as regard to age, gender, presence of bulky mediastinal mass, pleural effusion, stage and international prognostic indexes category of risk. Overall, 75.5% of patients in CR received IF-RT as consolidation. Complete remission was 51.1% in the CHOP group and 80% in MACOP-B/VACOP-B (P <0.001). Relapse occurred in 22.7% of CHOP- and in 9.2% of MACOP-B/VACOP-B-treated patients (n.s.). Event-free patients were 39.5% in CHOP and 75.7% in the MACOP-B/VACOP-B group (P <0.001). The addition of IF-RT as consolidation improved the outcome, irrespectively of the type of chemotherapy (P = 0.04). At a multivariate analysis, achievement of CR (P <0.0001) and type of CT (MACOP-B/VACOP-B) retained the significance for OS (P = 0.008) and EFS (P = 0.03). In our experience, MACOP-B/VACOP-B appears to positively influence OS and EFS in patients affected by PMLBCL, as compared to CHOP. Consolidation IF-RT on mediastinum further improves the outcome of CR patients.
AB - The optimal treatment of primary mediastinal large B-cell lymphoma (PMLBCL) is still undefined. In the absence of randomised studies, we retrospectively analysed: (a) the effectiveness of two chemotherapy regimens (CHOP vs MACOP-B/VACOP-B) in complete remission (CR) achievement and event-free survival (EFS) and (b) the role of mediastinal involved-field radiotherapy (IF-RT) as consolidation. From 1982 to 1999, 138 consecutive patients affected by PMLBCL were treated in 13 Italian institutions with CHOP (43) or MACOP-B/VACOP-B (95), The two groups of patients were similar as regard to age, gender, presence of bulky mediastinal mass, pleural effusion, stage and international prognostic indexes category of risk. Overall, 75.5% of patients in CR received IF-RT as consolidation. Complete remission was 51.1% in the CHOP group and 80% in MACOP-B/VACOP-B (P <0.001). Relapse occurred in 22.7% of CHOP- and in 9.2% of MACOP-B/VACOP-B-treated patients (n.s.). Event-free patients were 39.5% in CHOP and 75.7% in the MACOP-B/VACOP-B group (P <0.001). The addition of IF-RT as consolidation improved the outcome, irrespectively of the type of chemotherapy (P = 0.04). At a multivariate analysis, achievement of CR (P <0.0001) and type of CT (MACOP-B/VACOP-B) retained the significance for OS (P = 0.008) and EFS (P = 0.03). In our experience, MACOP-B/VACOP-B appears to positively influence OS and EFS in patients affected by PMLBCL, as compared to CHOP. Consolidation IF-RT on mediastinum further improves the outcome of CR patients.
KW - CHOP
KW - MACOP-B/VACOP-B
KW - PMLBCL
UR - http://www.scopus.com/inward/record.url?scp=10744224539&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=10744224539&partnerID=8YFLogxK
U2 - 10.1038/sj.bjc.6601460
DO - 10.1038/sj.bjc.6601460
M3 - Article
C2 - 14735179
AN - SCOPUS:10744224539
VL - 90
SP - 372
EP - 376
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
IS - 2
ER -