The role of local radiotherapy following rituximab-containing chemotherapy in patients with transformed indolent B-cell lymphoma.

Abstract

OBJECTIVES:

This study aimed to evaluate the outcomes of local radiotherapy (LRT) in patients with histologic transformation (HT) following rituximab-containing chemotherapy.

METHODS:

We retrospectively analysed 92 patients with biopsy-confirmed HT undergoing rituximab-containing chemotherapy at our institution between 2003 and 2015.

RESULTS:

Of the 36 patients with limited-stage disease at diagnosis of HT, 29 (78%) received LRT. The estimated 5-year progression-free survival (PFS) rate was significantly better in patients who underwent LRT than in those who did not (93% and 42%, respectively; P < 0.05). Multivariate analyses employing age, sex, performance status, LRT and treatment response demonstrated that LRT was an independent prognostic factor for PFS (hazard ratio [HR]: 11.8; 95% confidence interval [CI]: 1.28-108.1; P < 0.05). Of the 32 patients who underwent LRT for HT lesion treatment, 31 (97%) did not show disease progression within radiation fields; among them, 27 patients (84%) survived without disease progression during the follow-up period. One patient developed hypothyroidism due to LRT; the others had no acute or late-onset complications of LRT.

CONCLUSIONS:

Our data support the recommendation of LRT for HT lesion treatment following rituximab-containing chemotherapy in select patients with localised HT, as a rational treatment approach with potentially limited toxicity.

• Authors: Kenji Nozaki, Dai Maruyama, Akiko Miyagi Maeshima, Kinuko Tajima, Jun Itami, Takafumi Shichijo, Sayako Yuda, Tomotaka Suzuki, Kosuke Toyoda, Nobuhiko Yamauchi, Shinichi Makita, Suguru Fukuhara, Wataru Munakata, Yukio Kobayashi, Hirokazu Taniguchi, Koji Izutsu, Kensei Tobinai
• Journal: European journal of haematology (Eur J Haematol) Vol. 106 Issue 2 Pg. 213-220 (Feb 2021) ISSN: 1600-0609 [Electronic] England
• PMID: 33098704 (Publication Type: Journal Article)
• Copyright: © 2020 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.

Chemical References

• Rituximab

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Chemoradiotherapy
• Combined Modality Therapy
• Humans
• Lymphoma, B-Cell (diagnosis, mortality, therapy)
• Middle Aged
• Neoplasm Grading
• Neoplasm Staging
• Positron Emission Tomography Computed Tomography
• Prognosis
• Radiotherapy, Adjuvant (methods)
• Retrospective Studies
• Rituximab (administration & dosage)
• Treatment Outcome