Radiation for diffuse large B‐cell lymphoma in the rituximab era: Analysis of the National Comprehensive Cancer Network lymphoma outcomes project. Issue 7 (9th December 2014)

• Record Type: Journal Article
• Authors: Dabaja, Bouthaina S.; Vanderplas, Ann M.; Crosby‐Thompson, Allison L.; Abel, Gregory A.; Czuczman, Myron S.; Friedberg, Jonathan W.; Gordon, Leo I.; Kaminski, Mark; Niland, Joyce; Millenson, Michael; Nademanee, Auayporn P.; Zelenetz, Andrew; LaCasce, Ann S.; Rodriguez, Maria Alma
• Is Part Of: Cancer. Volume 121:Issue 7(2015)
• Page Start: 1032
• Page End: 1039
• Publication Date: 2014-12-09
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.29113
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr29113-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The role of consolidation radiotherapy was examined for patients with diffuse large B‐cell lymphoma who were treated at institutions of the National Comprehensive Cancer Network during the rituximab era.</p> </sec> <sec id="cncr29113-sec-0002" sec-type="section"> <title>METHODS</title> <p>Failure‐free survival (FFS) and overall survival (OS) were analyzed in terms of patient and treatment characteristics. Potential associations were investigated with univariate and multivariate survival analysis and matched pair analysis.</p> </sec> <sec id="cncr29113-sec-0003" sec-type="section"> <title>RESULTS</title> <p>There were 841 patients, and most (710 or 84%) received 6 to 8 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R‐CHOP); 293 (35%) received consolidation radiation therapy (RT). Failure occurred for 181 patients: 126 patients (70%) who did not receive RT and 55 patients (30%) who did. At 5 years, both OS and FFS rates were better for patients who had received RT versus those who did not (OS, 91% vs 83% [<italic>P</italic> = .01]; FFS, 83% vs 76% [<italic>P</italic> = .05]). A matched pair analysis (217 pairs matched by age, stage, International Prognostic Index [IPI] score, B symptoms, disease bulk, and response to chemotherapy) showed that the receipt of RT improved OS (hazard ratio [HR], 0.53 [<italic>P</italic> = .07]) and FFS (HR, 0.77 [<italic>P</italic> = .34]) for patients with stage III/IV disease, but too few events took place among those with stage I/II disease for meaningful comparisons (HR for OS, 0.94 [<italic>P</italic> = .89]; HR for FFS, 1.81 [<italic>P</italic> = .15]). A multivariate analysis suggested that the IPI score and the response to chemotherapy had the greatest influence on outcomes.</p> </sec> <sec id="cncr29113-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>There was a trend of higher OS and FFS rates for patients who had received consolidation RT after R‐CHOP (especially for patients with stage III/IV disease), but the difference did not reach statistical significance. <bold><italic>Cancer</italic> 2014.</bold> © <italic>2014 American Cancer Society</italic>. <bold><italic>Cancer 2015;121:1032–1039</italic>.</bold> © <italic>2014 American Cancer Society</italic>.</p> </sec> </abstract>