Benefit of Consolidative Radiation Therapy for Primary Bone Diffuse Large B-Cell Lymphoma

Tao, Randa; Allen, Pamela K.; Rodriguez, Alma; Shihadeh, Ferial; Pinnix, Chelsea C.; Arzu, Isidora; Reed, Valerie Klairisa; Oki, Yasuhiro; Westin, Jason R.; Fayad, Luis; Medeiros, L. Jeffrey; Dabaja, Bouthaina S.

doi:10.1016/j.ijrobp.2015.01.014

Cited by 42 publications

(49 citation statements)

References 20 publications

(23 reference statements)

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“…This hypothesis is supported by recent data by Tao and colleagues, suggesting that RT may be useful as a consolidation modality after conventional immunochemotherapy in PB-DLBCL. [14] In a large study on DLBCL with skeletal involvement (which included 52 cases of PB-DLBCL), Held and coworkers also demonstrated a positive impact of radiotherapy on survival. [31] The question of RT as a therapeutic modality in PB-DLBCL -in combination with immunochemotherapy -may represents a pivotal question for future prospective clinical trials.…”

Section: Discussionmentioning

confidence: 99%

“…These results require further validation in larger/prospective cohorts but suggest that outside of clinical trials, PET scan positivity should not be used as a decision marker for salvage therapy regardless the overall context, as suggested by other reports. [29] The role of radiation therapy (RT) remains a matter of debate in DLBCL as a consolidation modality after chemotherapy [5,14,30] In our study, post-induction RT was given to 11 (33%) patients from the PBL cohort but was not part of any LNH03 protocol, preventing any relevant comparison of survival data regarding RT. However, 10 of the 11 patients of the PBL cohortmostly localized diseases -treated with radiotherapy as a consolidation strategy after immunochemotherapy experienced long-term complete remission, suggesting a potential favorable impact of this strategy.…”

Section: Discussionmentioning

confidence: 99%

“…[12,13] Combined radio/chemotherapy strategy appeared promising in some studies but has to be evaluated more widely in PB-DLBCL. [14] In most studies, histological subtypes and clinical entities (i.e. primary versus systemic bone involvement) of lymphoma are mixed.…”

Section: Introductionmentioning

confidence: 99%

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Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Pilorge

Harel

Ribrag

et al. 2016

Leukemia & Lymphoma

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Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is a rare DLBCL location variant. We treated 76 PB-DLBCL patients by immuno-chemotherapy, resulting in an 84% sustained complete remission rate and a 78.9% survival over a 4.7-year median follow-up period. Ann Arbor stage IV and high age-adjusted international prognostic index were predictive of adverse outcome in univariate analysis. In multivariate analysis using a Cox model, only aa-IPI predicted long-term survival. While based on a limited number of cases, we suggested that radiotherapy may be useful as a consolidation modality in PB-DLBCL. We also suggested that positron emission tomography/ CT scan should be interpreted with caution due to a persistent [18F]fluorodeoxyglucose [18FDG] uptake of bone lesions even after remission in some in PB-DLBCL patients. Our study based on a homogeneous cohort of PB-DLBCL patients confirmed the favorable outcome of this DLBCL variant and support the implementation of prospective clinical trials in this disease. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Pilorge

Harel

Ribrag

et al. 2016

Leukemia & Lymphoma

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show abstract

“…GTV_Lumbar was expanded isotropically by a 1 cm margin and was modified to include the entire postoperative bed as well as the left psoas muscle to generate the clinical target volume (CTV_Lumbar) 3. GTV_Femur was also expanded similarly and modified to include the entire head, neck and greater trochanter of the left femur (CTV_Femur).…”

Section: Treatmentmentioning

confidence: 99%

Case of polyostotic primary bone lymphoma successfully treated with immunochemotherapy and consolidation radiotherapy

Ahmad¹,

Chufal

Goyal³

et al. 2017

BMJ Case Reports

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A 47-year-old woman presented with symptoms of sharp pain over the left anterior thigh with radiation from the groin to the knee. She subsequently developed numbness in that region and reduced motor strength in extensors of the left knee. Plain radiography of the spine and knee was normal. An MRI of the spine revealed an irregular extramedullary mass with intradural and extradural components, extending from the L3 to L5 vertebrae. She underwent a laminectomy and posterior spinal decompression based on a working diagnosis of nerve sheath tumour. Histopathology revealed a primary bone lymphoma. A positron emission tomography CT (PET-CT) performed as part of the staging workup revealed fluorodeoxyglucose avid lesions in the spine and left femur. She received immunochemotherapy (Rituximab-Cyclophosphamide, Hydroxydaunorubicin, Oncovin and Prednisone) for eight cycles with an interim PET-CT revealing complete response. Subsequently, she received consolidation radiotherapy, 36 Gy in 20 fractions over 4 weeks to both lesions. She is now disease-free on follow-up for the past 1 year.

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“…Intrathecal chemotherapy or intravenous Methotrexate prophylaxis could reduce this risk [22]. However, CNS prophylaxis in PLB remains controversial, considering such relapse risk rate was halved in DLBCL patient when Rituximab therapy incorporated with chemotherapy [15].…”

Section: Treatmentmentioning

confidence: 99%

Primary Lymphoma of Bone Literature Review

Elhassadi¹

2017

J Orthop Oncol

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Primary Lymphoma of Bone (PLB) is a very rare neoplasm presenting most commonly with bone pain and swelling or as an incidental finding on imaging. PLB diagnosis requires tissue biopsy and Non-Hodgkin's lymphoma (NHL) is the commonest sub-type. Disease staging includes thoracic-abdominal-pelvic computed tomography scan (CT), bone marrow biopsy and cerebrospinal fluid cytology. Chemo-immunotherapy with radiotherapy (RT) consolidation is a widely applied treatment strategy for PLB with good outcomes achieved.

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Benefit of Consolidative Radiation Therapy for Primary Bone Diffuse Large B-Cell Lymphoma

Cited by 42 publications

References 20 publications

Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Case of polyostotic primary bone lymphoma successfully treated with immunochemotherapy and consolidation radiotherapy

Primary Lymphoma of Bone Literature Review

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