Primary mediastinal large B-cell lymphoma (PMLBCL): Long-term results from a retrospective multicentre Italian experience in 138 patients treated with CHOP or MACOP-B/VACOP-B

G. Todeschini, S. Secchi, E. Morra, U. Vitolo, E. Orlandi, F. Pasini, E. Gallo, A. Ambrosetti, C. Tecchio, C. Tarella, A. Gabbas, A. Gallamini, L. Gargantini, M. Pizzuti, G. Fioritoni, L. Gottin, G. Rossi, M. Lazzarino, F. Menestrina, M. PaulliM. Palestro, M. G. Cabras, F. Di Vito, G. Pizzolo

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)372-376
Number of pages5
JournalBritish Journal of Cancer
Volume90
Issue number2
DOIs
Publication statusPublished - Jan 26 2004

Keywords

  • CHOP
  • MACOP-B/VACOP-B
  • PMLBCL

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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