TY - JOUR
T1 - Radiation therapy improves treatment outcome in patients with diffuse large B-cell lymphoma
AU - Marcheselli, Luigi
AU - Marcheselli, Raffaella
AU - Bari, Alessia
AU - Liardo, Elianavalentina
AU - Morabito, Fortunato
AU - Baldini, Luca
AU - Brugiatelli, Maura
AU - Merli, Francesco
AU - Renzo, Nicola Di
AU - Sacchi, Stefano
PY - 2011/10
Y1 - 2011/10
N2 - The effects of radiotherapy (RT) after chemotherapy in patients with diffuse large B-cell lymphoma (DLBCL) remain unclear; several trials have yielded conflicting results. This study examined the effect of RT after cyclophosphamide, doxorubicin, vincristine, and prednisone + rituximab (R-CHOP) treatment on event-free (EFS) and overall (OS) survival. Data from 216 patients with DLBCL who were enrolled in two clinical trials at Italian Lymphoma Study Group sites and were subjected to six R-CHOP cycles and involved-field radiotherapy (IFRT) were retrospectively analyzed. IFRT treatment yielded significant EFS benefit, with a 66% reduction in the risk of death and/or disease progression. Cox analysis, when adjusted for age, gender, stage, performance status (PS), lactate dehydrogenase (LDH), and disease bulk, confirmed the significant EFS benefit of IFRT. The role of RT in DLBCL in the rituximab era is unclear. Future studies must take into account new radiation techniques and the response to chemotherapy based on functional imaging. Prospective randomized trials incorporating response-adapted therapy and modern radiation techniques are needed.
AB - The effects of radiotherapy (RT) after chemotherapy in patients with diffuse large B-cell lymphoma (DLBCL) remain unclear; several trials have yielded conflicting results. This study examined the effect of RT after cyclophosphamide, doxorubicin, vincristine, and prednisone + rituximab (R-CHOP) treatment on event-free (EFS) and overall (OS) survival. Data from 216 patients with DLBCL who were enrolled in two clinical trials at Italian Lymphoma Study Group sites and were subjected to six R-CHOP cycles and involved-field radiotherapy (IFRT) were retrospectively analyzed. IFRT treatment yielded significant EFS benefit, with a 66% reduction in the risk of death and/or disease progression. Cox analysis, when adjusted for age, gender, stage, performance status (PS), lactate dehydrogenase (LDH), and disease bulk, confirmed the significant EFS benefit of IFRT. The role of RT in DLBCL in the rituximab era is unclear. Future studies must take into account new radiation techniques and the response to chemotherapy based on functional imaging. Prospective randomized trials incorporating response-adapted therapy and modern radiation techniques are needed.
KW - DLBCL
KW - EFS
KW - NHL
KW - OS
KW - R-CHOP
KW - radiotherapy
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UR - http://www.scopus.com/inward/citedby.url?scp=80053187274&partnerID=8YFLogxK
U2 - 10.3109/10428194.2011.585526
DO - 10.3109/10428194.2011.585526
M3 - Article
C2 - 21663499
AN - SCOPUS:80053187274
VL - 52
SP - 1867
EP - 1872
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
SN - 1042-8194
IS - 10
ER -