Abstract
As the optimal treatment for primary mediastinal large B-cell lymphoma (PMBCL) remains undefined, we evaluated outcomes of patients treated with standard and dose-intense rituximab-chemotherapy (R-CT) with and without radiotherapy (RT). We retrospectively identified 28 patients with stage I-II PMBCL in our lymphoma database, re-reviewed pathology slides and scored interim or post-chemotherapy PET/CTs using the Deauville scale. Fourteen patients received RT (36-45 Gy) preceded by either six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or 12 weeks of rituximab, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and bleomycin (R-VACOP-B) with median follow-up of 94 months. Fourteen patients received 4-8 cycles of dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide and rituximab (DA-EPOCH-R) with median follow-up of 38 months; one of these received RT (36 Gy) due to post-chemotherapy PET/CT Deauville score 4. Following R-CT and RT or DA-EPOCH-R, 5-year and 3-year FFP and OS were both 100%. Both R-CHOP/R-VACOP-B with RT and DA-EPOCH-R demonstrate excellent outcomes.
Keywords:
Primary mediastinal large B-cell lymphoma.
Publication types
-
Research Support, Non-U.S. Gov't
MeSH terms
-
Adult
-
Aged
-
Antibodies, Monoclonal, Murine-Derived / adverse effects
-
Antibodies, Monoclonal, Murine-Derived / therapeutic use
-
Antineoplastic Combined Chemotherapy Protocols / adverse effects
-
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
-
Bleomycin / adverse effects
-
Bleomycin / therapeutic use
-
Combined Modality Therapy
-
Cyclophosphamide / adverse effects
-
Cyclophosphamide / therapeutic use
-
Doxorubicin / adverse effects
-
Doxorubicin / therapeutic use
-
Etoposide / adverse effects
-
Etoposide / therapeutic use
-
Female
-
Fluorodeoxyglucose F18
-
Follow-Up Studies
-
Humans
-
Lymphoma, Large B-Cell, Diffuse / diagnosis*
-
Lymphoma, Large B-Cell, Diffuse / mortality
-
Lymphoma, Large B-Cell, Diffuse / therapy*
-
Male
-
Mediastinal Neoplasms / mortality
-
Mediastinal Neoplasms / pathology*
-
Mediastinal Neoplasms / therapy*
-
Middle Aged
-
Neoplasm Staging
-
Positron Emission Tomography Computed Tomography
-
Prednisone / adverse effects
-
Prednisone / therapeutic use
-
Prognosis
-
Radiotherapy* / methods
-
Retrospective Studies
-
Rituximab
-
Tomography, X-Ray Computed
-
Treatment Outcome
-
Vincristine / adverse effects
-
Vincristine / therapeutic use
-
Young Adult
Substances
-
Antibodies, Monoclonal, Murine-Derived
-
R-CHOP protocol
-
Fluorodeoxyglucose F18
-
Bleomycin
-
Rituximab
-
Vincristine
-
Etoposide
-
Doxorubicin
-
Cyclophosphamide
-
Prednisone