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.
Corresponding Authors:
Zhu Yuan, Department of Radiation Oncology, Zhejiang Cancer Hospital, Key Laboratory of Radiation Oncology in Zhejiang Province,Hangzhou 310022,China;Email:zhuyuan63@hotmail.com
Cite this article:
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.
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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