Abstract：Objective To investigate the value of radiotherapy (RT) in patients with early diffuse large B-cell lymphoma (DLBCL) who have achieved a complete remission (CR) after chemotherapy. Methods A retrospective analysis was performed on 376 patients with stage Ⅰ and Ⅱ DLBCL who were admitted to our hospital from 2004 to 2012. All patients achieved a CR after receiving chemotherapy with cyclophosphamide, doxorubicin/epirubicin, vincristine and prednisone (CHOP) or rituximab combined with CHOP (R-CHOP) for at least three cycles. The median age was 53 years. Patients were divided into four groups:R-CHOP group (n=92), R-CHOP+RT group (n=79), CHOP group (n=107), and CHOP+RT group (n= 98). The RT used was involved-field irradiation and the total dose ranged from 30 to 56 Gy. The survival rate was determined using the Kaplan-Meier method, and the survival difference analysis was performed using the log-rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model. Results The 5-year sample size was 188. The 5-year disease-free survival (DFS) and overall survival (OS) rates in all patients were 80.7% and 87.6%, respectively. The 5-year DFS and OS rates in the R-CHOP+RT group were significantly higher than those in the R-CHOP group (94.9% vs. 88.1%, P=0.030;97.9% vs. 86.0%, P=0.026). No significant differences in DFS and OS rates were observed between the CHOP+RT and CHOP groups (74.2% vs. 71.4%, P=0.623;74.2% vs. 71.4%, P=0.623). Multivariate prognostic analysis revealed that the smoking index<500, international prognostic index<2, and use of rituximab were favorable prognostic factors (P=0.034－0.000). Conclusions Radiotherapy can improve the DFS and OS in early DLBCL patients with CR after R-CHOP chemotherapy. All early stage DLBCL patients are recommended to undergo rituximab-containing chemotherapy followed by radiotherapy. Randomized controlled trials are needed to validate the results.
Liu Jianjiang,Zhang Na,Liu Luying et al. Clinical value of radiotherapy in early DLBCL patients with complete remission after chemotherapy[J]. Chinese Journal of Radiation Oncology, 2015, 24(2): 138-142.
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2015, Vol. 24 
