Retracted: Adjuvant Radiotherapy in Stage IV Diffuse Large Cell Lymphoma Improve Outcome

Abstract

The role of adjuvant radiotherapy to sites of nodal bulky disease in patients with aggressive diffuse large cell lymphoma (DLCL), and stage IV remain undefined. We began a prospective controlled clinical trial to evaluate impact in event free survival (EFS) and overall survival (OS) in a large cohort of patients with a longer follow-up. Between 1989 and 1995; 341 patients with aggressive DLCL and presence of nodal bulky disease (tumor mass > 10 cm) in pathological proven complete response after intensive chemotherapy were randomized to received either radiotherapy (involved fields, 40 Gy) or not. The 5-year EFS and OS in radiated patients were respectively: 82% (95% Confidence interval (CI): 70-89%) and 87% (95% 80-99%), that were statistically significant to control group: 55% (41-64%) (P < 0.001) and 66% (95% CI: 51-73%) (P < 0.01) respectively. Radiotherapy was well tolerated, acute toxicity was mild and until now late toxicity did not appear. The use of adjuvant radiotherapy improve EFS and OS and probably the possibility of cure in patients diffuse large cell lymphoma with worse prognostic factors. Thus, we felt that adjuvant radiotherapy will be considered as part of the initial treatment in this setting of patients.

Diffuse large B-cell lymphoma: optimizing outcome in the context of clinical and biologic heterogeneity

“…Although historical comparative trials suggested a possible benefit, [86][87][88] recent improvement in systemic therapy may have diminished its role. To date, there have been no randomized trials evaluating the role of consolidative radiation therapy in DLBCL in the rituximab era.…”

Czy należy stosować radioterapię w nieziarniczym rozlanym chłoniaku z dużych komórek B? Głos na tak

“…Natomiast rola radioterapii jest marginalna. Wpływ napromieniania zmian resztkowych po leczeniu systemowym bez rytuksymabu u chorych z guzami > 10 cm oceniono w kilku prospektywnych i retrospektywnych badaniach [29][30][31][32][33], a po leczeniu R-CHOP w trzech retrospektywnych badaniach z MDACC i Duke University oraz Emory University [34][35][36]. We wszystkich wykazano korzyść z radioterapii w odniesieniu do pięcioletniej kontroli miejscowej, czasu do progresji, a także w odniesieniu do ogólnego czasu przeżycia.…”

The Role of Consolidative Radiotherapy after a Complete Response to Chemotherapy in the Treatment of Diffuse Large B-Cell Lymphoma in the Rituximab Era: Results from a Systematic Review with a Meta-Analysis

“…Researchers focus on supplemental treatment such as radiation therapy (RT). In the prerituximab era, several studies found a recurrence in 52-65% of patients who had achieved an initial complete response (CR) to chemotherapy alone, while consolidation RT after CHOP chemotherapy could decrease the risk of disease recurrence and improve the outcome of patients with stage I-IV DLBCL [2,3,4,5]. …”