Role of radiotherapy in the treatment of primary mediastinal large B-cell lymphoma

Abstract

Abstract. The role of radiotherapy (RT) in the treatment of primary mediastinal large B-cell lymphoma (PMLBCL) is unclear. In the present study, a retrospective analysis of 63 patients with PMLBCL treated with or without RT was performed to evaluate the role of RT. Clinical outcomes were calculated using the Kaplan-Meier method and were compared between patients who did and did not receive RT, using the log-rank test. A multivariate analysis was performed using Cox proportional hazards model. After chemotherapy, 35 patients received RT, and RT was found to be associated with significantly improved 5-year overall survival (OS) (87 vs. 58%; P=0.001) and 5-year progression-free survival (PFS) (75 vs. 39%; P=0.001) rates compared with patients without RT. The subgroup analysis on 35 patients who received rituximab plus chemotherapy showed that RT did not improve the 5-year OS (88 vs. 92%; P=0.814) or the 5-year PFS (78 vs. 65%; P=0.511) rates compared with patients without RT. On multivariate analysis, RT and the addition of rituximab were predictive of increased OS [RT: Hazard ratio (HR), 0.157; P=0.018; rituximab: HR, 0.156; P=0.009] and PFS (RT: HR 0.111, P=0.001; Rituximab: HR 0.231, P=0.002) rates. However, the role of RT in PMLBCL in the rituximab era is unclear. Further investigation of the role of RT in the era of targeted therapy is required.

A retrospective analysis of outcomes for primary mediastinal large B-cell lymphoma treated with RCHOP followed by radiotherapy or front-line autologous stem cell transplantation

“…Research from Korea demonstrated subsequent radiation did not produce a survival difference in terms of OS and PFS regardless of CHOP or RCHOP [4]. Wang et al did not conclude the positive significant role of subsequent IFRT after anthracyclinebased chemotherapy in PMBL patients [20]. More recent single institution data showed good OS rate of 79% by prospective study of dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine, prednisone, and rituximab (DA-EPOCH-R) without subsequent IFRT [21].…”

Diagnostic Accuracy of Amino Acid and FDG-PET in Differentiating Brain Metastasis Recurrence from Radionecrosis after Radiotherapy: A Systematic Review and Meta-Analysis

“…3 More recently, radiation therapy, particularly stereotactic radiosurgery (SRS), has become an increasingly important treatment option for the initial management of patients with brain metastasis. 4 The efficacy of SRS, when used alone or combined with whole-brain radiation therapy, has been demonstrated in Phase III studies and has shown a 12-month local control rate of 70%-90%. [5][6][7][8] One of the most common complications after SRS for brain metastasis is radiation injury.…”