Long-term efficacy of CHOP-based chemotherapy alone or combined with radiotherapy for adolescent/childhood primary systemic anaplastic large-cell lymphoma
Fang Hui, Zhang Ximei, Jin Jing, Wang Weihu, Song Yongwen, Liu Yueping, Wang Shulian, Ren Hua, Yu Zihao, Liu Xinfan, Li Yexiong
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
Abstract：Objective To investigate the long-term efficacy of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)-based chemotherapy alone or combined with regional radiotherapy for adolescent/childhood primary systemic anaplastic large-cell lymphoma (ALCL). Methods A retrospective analysis was performed on the medical records of 28 patients not older than 21 years with a confirmed diagnosis of primary systemic ALCL, who were admitted to our hospital from January 1998 to December 2010. Of 12 stage Ⅰ/Ⅱ patients, 2 received chemotherapy alone, and 10 received chemotherapy and radiotherapy;of 16 stage Ⅲ/IV patients, 14 received chemotherapy alone, and 2 received chemotherapy and radiotherapy. CHOP regimen was adopted in 15 patients, and CHOP regimen combined with other high-intensity regimens was adopted in 13 patients. There were 3—17 chemotherapy cycles (median:6 cycles). Radiotherapy was performed mainly by involved field radiation, with a dose of 39.6—50.0 Gy (median:45 Gy). Results After the first course of treatment, 25(89%) of all patients achieved a complete remission (CR), and 3 patients experienced disease progression. With a median follow-up of 45.3 months, the 5-year event-free survival (EFS) and overall survival (OS) for all patients were 80% and 93%, respectively. The 5-year OS was 100% for patients achieving a CR after treatment, versus 0% for those not achieving a CR (P=0.000). The 5-year EFS was 38% for patients with involvement of ≥2 extranodal organs, versus 85% for those with involvement of<2 extranodal organs (P=0.010). Conclusions CHOP chemotherapy combined with regional radiotherapy (for patients with localized disease) is an effective treatment for adolescent/childhood primary systemic ALCL, but long-term follow-up is needed to investigate treatment-related toxicities.
Fang Hui,Zhang Ximei,Jin Jing et al. Long-term efficacy of CHOP-based chemotherapy alone or combined with radiotherapy for adolescent/childhood primary systemic anaplastic large-cell lymphoma[J]. Chinese Journal of Radiation Oncology, 2014, 23(3): 187-189.
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