Chemotherapy for management of localised high-grade gastric B-cell lymphoma: how much is necessary?

Raderer, Markus; Chott, Andreas; Drach, Johannes; Montalbán, Carlos; Dragosics, B; Jäger, Ulrich; Püspök, Andreas; Österreicher, C.; Zielinski, C C

doi:10.1093/annonc/mdf178

Cited by 56 publications

(22 citation statements)

References 17 publications

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“…32 Previous studies have shown that HPE combined with chemotherapy in gastric pure DLBCL patients can increase treatment efficacy compared with chemotherapy alone. 33 We also found that H pylori-positive gastric pure DLBCL patients displayed a lower rate of tumor progression, better tumor response to chemotherapy, and better overall survival than those without H pylori infection. 34 These findings indicate that H pylori-related gastric pure DLBCL may share common clinicopathological and biological features with H pylori-related gastric MALT lymphoma.…”

Section: H Pylori-positive Gastric Pure Dlbcl Is Dependent On H Pylorsupporting

confidence: 52%

Helicobacter pylori and mucosa-associated lymphoid tissue: what's new

Kuo

Cheng

2013

Hematology

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Section: H Pylori-positive Gastric Pure Dlbcl Is Dependent On H Pylorsupporting

confidence: 52%

Helicobacter pylori and mucosa-associated lymphoid tissue: what's new

Kuo

Cheng

2013

Hematology

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“…As reported previously, H. pylori eradication resulted in durable histologically confirmed CR in 50-63% of patients with gastric DLBCL and concomitant MALT (35). The eradication of H. pylori may be necessary in PG-DLBCL, particularly in cases of concomitant MALT lymphoma (36).…”

Section: Discussionmentioning

confidence: 55%

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

Kobayashi

Hatta

Hojo

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. The addition of rituximab to cyclophosphamide, doxorubicin, vincristine and prednisone [CHOP (i.e., R-CHOP)] is considered to be the standard regimen for treating localized, primary gastric diffuse large B-cell lymphoma (PG-DLBCL). However, few studies have reported the long-term efficacy of R-CHOP therapy in the management of localized PG-DLBCL. In the present study, we performed a retrospective analysis of 11 patients with localized PG-DLBCL, who were treated with R-CHOP at Nihon University Itabashi Hospital and Kasukabe Municipal Hospital (Japan) from 2001 to 2008. Limited stage cancer was defined as stage I/II according to the Lugano staging system for gastrointestinal (GI) lymphomas. The relative dose intensity (RDI) of CHOP therapy was calculated for each patient. The median age of the patients was 68 years (range, 48-82). Gastralgia and anemia were common symptoms at initial presentation. All patients except 1 received 6 cycles of R-CHOP treatment without consolidative radiation therapy or prior surgery. RDI was maintained at over 80% in 9 out of 11 patients. All patients achieved complete remission and the estimated overall survival with a median follow-up of 54 months (range, 39-103) was 100%, without relapse or significant GI adverse effects, such as perforation or bleeding during R-CHOP treatment. No long-term adverse effects of rituximab were recorded during the observation period. Helicobacter pylori infection was diagnosed in 72.7% (8 cases) of the patients, but was eradicated in a limited number of patients. Our data suggest the feasibility and effectiveness of the addition of rituximab to conventional CHOP therapy in the management of localized PG-DLBCL.

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“…The role of chemotherapy alone has been suggested because there are many active drugs. 6,36,37 Rituximab has clinical activity with a response rate of 73% and a median response duration of 10.5 months reported in 1 study. 38 However, a large retrospective study conducted by the International Extra Nodal Lymphoma Study Group (IELSG) analyzing the results of 180 patients did not find any difference in clinical outcome between initial localized treatment approaches with systemic chemotherapy.…”

Section: Discussionmentioning

confidence: 95%

Long‐term outcome in localized extranodal mucosa‐associated lymphoid tissue lymphomas treated with radiotherapy

Goda

Gospodarowicz

Pintilie

et al. 2010

Cancer

188

126

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BACKGROUND: This study was conducted to evaluate the long-term outcomes in patients with stage IE and IIE mucosa-associated lymphoid tissue (MALT) lymphomas treated with involved field radiotherapy (RT). METHODS: Between 1989 and 2004, 192 patients with stage I and II MALT lymphomas were treated. The report focuses on 167 patients who received RT. The median age of patients was 58 years with a female predominance (2:1). Presenting sites were as follows: orbital adnexa in 71 patients, salivary glands in 28 patients, stomach in 25 patients, thyroid in 21 patients, and other sites in 22 patients. The median dose to nonorbital sites was 30 grays (Gy) (range, 17.5-35 Gy) and was 25 Gy for the orbit (range, 25-35 Gy). The median follow-up was 7.4 years (range, 0.67-16.20 years). RESULTS: Complete response and complete response, unconfirmed (CR/CRu) was noted in 166 (99%) patients. The 10-year recurrence-free rate (RFR) was 76%, the disease-free survival (DFS) rate was 68%, the overall survival (OS) rate was 87%, and the cause-specific survival rate was 98%. According to presenting site, the 10-year RFR was 95% for thyroid, 92% for stomach, 68% for salivary glands, and 67% for orbit. Patients with thyroid and gastric MALTs had better outcome compared with patients with MALTs diagnosed at other sites (P ¼.004). Among those patients who achieved CR, 19% developed disease recurrence (n ¼ 31), chiefly in distant sites or untreated contralateral-paired organs. At the time of disease recurrence, 7 patients (23%) had transformed to diffuse large B-cell lymphoma, 2 of whom died of lymphoma. The 5-year OS rate after treatment failure was 83%. CONCLUSIONS: Patients with localized MALT lymphomas are reported to have excellent clinical outcome after moderate-dose RT, and some are likely cured. In the current study, thyroid and gastric MALTs were found to have significantly less risk of distant recurrence. Despite disease recurrence, the overall survival remains excellent in these patients. Cancer 2010;116:3815-24.

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Chemotherapy for management of localised high-grade gastric B-cell lymphoma: how much is necessary?

Cited by 56 publications

References 17 publications

Helicobacter pylori and mucosa-associated lymphoid tissue: what's new

Helicobacter pylori and mucosa-associated lymphoid tissue: what's new

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

Long‐term outcome in localized extranodal mucosa‐associated lymphoid tissue lymphomas treated with radiotherapy

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