DLBCL is an aggressive lymphoma treated with R-CHOP. Recently, attempts have been made to improve the outcome by increasing both dose-density and intensity but there have been no benefits in terms of survival. When treating malignancies RDI is important to consider but there is little published information on DLBCL. The purpose of this study was to analyze the differential prognostic impact of RDI in two cohorts of DLBCL patients treated with R-CHOP21 or R-CHOP14. From January 2001 to August 2013 we included DLBCL patients homogenously treated with R-CHOP21 or R-CHOP14, with or without radiotherapy, at University Hospital Son Espases, Hospital Son Llatzer of Palma and Hospital del Mar of Barcelona (N = 157). In order to avoid selection bias the patients were retrospectively identified from the Pathology Department and Pharmacy registries. Median follow-up was 68 months. There was no difference in the response or survival between the two cohorts. In the R-CHOP21 group, both a reduction higher than 15% in RDI (RR 7.41) and R-IPI (RR 2.99) were independently associated with OS. However, a reduction higher than 15% in RDI (RR 4.41) was only noted for PFS. In the R-CHOP14 group, NCCN-IPI (RR 7.09) and B-symptoms (RR 5.37) for OS; AA stage III-IV (RR 6.26) and bulky disease (RR 4.05) for PFS. There was a trend towards a higher rate of RDI reduction observed in the R-CHOP14 group but it only made an impact in the R-CHOP21 group. We conclude that R-CHOP21 and R-CHOP14 are equivalent regimens in terms of response and survival, but only if RDI reductions are avoided. For patients receiving R-CHOP21 we recommend using clinical and support measures in order to avoid RDI reductions.

The administration of adjuvant CT-based taxanes reduces the risk of relapse and death. This reduction is superior in clinical trials that included only N+ patients. With the available evidence, it would appear that the best method of administering paclitaxel is weekly and for docetaxel tri-weekly.

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S356reports of practical oncology and radiotherapy 1 8 ( 2 0 1 3 ) S355-S358 metastases 2 months after treatment. Secondly, we report a 79-year-old man with an ulcer in the left ear. It was excised. Pathology showed EP with close surgical margin; it was widened. Workup showed no distant metastases. In February 2010 conformational 3-D RT was administered (30 sessions). Treatment volumes: PTV1:tumor bed (TD: 60 Gy); PTV2(TD: 54): left preauricular and cervical lymph node levels II-III. PTV1 was treated with a direct field (6 MeV electrons). The patient had acute toxicity: RTOG G1 dermatitis and alopecia and is in complete remission (2-year follow-up). Conclusions. EP diagnosis and management is difficult. Optimal treatment remains unknown. Early diagnosis and wide local excision show best results. Adjuvant RT can help achieve local control in EP with adverse factors, and in local and locoregional recurrences.http://dx.