Role of radiotherapy in patients with limited diffuse large B-cell lymphoma of Waldeyer's ring in remission after R-CHOP immunochemotherapy

Chunyan Li; Xuejun Ma; Ziqiang Pan; Fangfang Lv; Zuguang Xia; Kai Xue; Qunling Zhang; Dongmei Ji; Junning Cao; Xiaonan Hong; Ye Guo

doi:10.1016/j.leukres.2018.09.011

Role of radiotherapy in patients with limited diffuse large B-cell lymphoma of Waldeyer's ring in remission after R-CHOP immunochemotherapy

Leuk Res. 2018 Nov:74:80-85. doi: 10.1016/j.leukres.2018.09.011. Epub 2018 Sep 24.

Authors

Chunyan Li¹, Xuejun Ma², Ziqiang Pan³, Fangfang Lv⁴, Zuguang Xia⁵, Kai Xue⁶, Qunling Zhang⁷, Dongmei Ji⁸, Junning Cao⁹, Xiaonan Hong¹⁰, Ye Guo¹¹

Affiliations

¹ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
² Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
³ Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
⁴ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
⁵ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
⁶ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
⁷ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
⁸ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
⁹ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
¹⁰ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China. Electronic address: [email protected].
¹¹ Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China; Department of Oncology, Tongji University East Hospital, Shanghai, People's Republic of China. Electronic address: [email protected].

PMID: 30316031
DOI: 10.1016/j.leukres.2018.09.011

Abstract

The standard treatment of waldeyer's ring DLBCL remains controversial. This retrospective study was designed to evaluate the role of consolidation radiotherapy (RT) in patients with stage I/II diffuse large B-cell lymphoma (DLBCL) limited in Waldeyer's ring (WR). We included 72 patients, 42 were treated with immunochemotherapy alone (CT group) and 30 were treated with immunochemotherapy followed by radiotherapy (CT + RT group). All patients received at least 3 cycles of R-CHOP regimen and achieved complete remission (CR) after immunochemotherapy. After 53 months median follow-up time, the 5-year progression-free survival (PFS) rates in CT + RT group vs. CT group were 93.3% vs. 92.5% (P = 0.896), the 5-year overall survival (OS) rates were 96.7% vs. 94.4% (P = 0.649). Patients with oropharyngeal primary had relatively better 5-year PFS and OS rates compared to nasopharyngeal primary (PFS: 98.2% vs. 73.3%, p = 0.001; OS: 100% vs. 79.0%, p < 0.001). Moreover, the primary site was the only independent prognostic factor for PFS in the multivariate analysis (p = 0.012, HR 16.858 [95% CI: 1.883-150.933]).

Keywords: Diffuse large B-cell lymphoma; Immunochemotherapy; Radiotherapy; Waldeyer’s ring.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Antibodies, Monoclonal, Murine-Derived / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
Chemoradiotherapy*
Cyclophosphamide / administration & dosage
Disease-Free Survival
Doxorubicin / administration & dosage
Female
Follow-Up Studies
Humans
Lymphoma, Large B-Cell, Diffuse* / mortality
Lymphoma, Large B-Cell, Diffuse* / therapy
Male
Middle Aged
Neoplasm Staging
Prednisone / administration & dosage
Rituximab
Survival Rate
Vincristine / administration & dosage

Substances

Antibodies, Monoclonal, Murine-Derived
R-CHOP protocol
Rituximab
Vincristine
Doxorubicin
Cyclophosphamide
Prednisone