Radiotherapy with rituximab may be better than radiotherapy alone in first-line treatment of early-stage follicular lymphoma: is it time to change the standard strategy?

Leuk Lymphoma. 2015;56(8):2350-6. doi: 10.3109/10428194.2014.990010. Epub 2015 Jan 21.

Abstract

Early-stage follicular lymphoma (FL) has traditionally been treated with involved-field radiotherapy (RT). Rituximab (R) is a low-toxic, efficient systemic therapy for FL, but there are no data about its clinical impact in early FL. We retrospectively analyzed 93 patients with stage I-II indolent FL treated with RT (n=65) or RT+R (n=14) or R alone (n=14). Median follow-up was 5.0 years for patients with RT, 2.8 years for the RT+R subgroup and 2.5 years for patients treated with R. The complete response rate was 92%, 100% and 86% (not significant) and the median PFS was 3.3 years, not reached and 4.9 years (p=0.035) for the RT, RT+R and R arms, with no impact on overall survival. R combined with RT seems to give better results in terms of global FL control, but longer follow-up and prospective comparison are needed to verify these results.

Keywords: Follicular lymphoma; radiotherapy; rituximab.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemoradiotherapy
  • Combined Modality Therapy
  • Czech Republic / epidemiology
  • Databases, Factual
  • Female
  • Humans
  • Lymphoma, Follicular / epidemiology
  • Lymphoma, Follicular / pathology*
  • Lymphoma, Follicular / therapy*
  • Male
  • Middle Aged
  • Mortality
  • Neoplasm Staging
  • Radiotherapy* / methods
  • Rituximab / therapeutic use*
  • Standard of Care
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Rituximab