Predictors of local recurrence after rituximab-based chemotherapy alone in stage III and IV diffuse large B-cell lymphoma: guiding decisions for consolidative radiation.
Predictors of local recurrence after rituximab-based chemotherapy alone in stage III and IV diffuse large B-cell lymphoma: guiding decisions for consolidative radiation.
复制标题
在第三阶段和IV弥漫大型B细胞淋巴瘤中，仅基于利妥昔单抗化疗后局部复发的预测因素：巩固辐射的指导决定。
DOI：
10.1016/j.ijrobp.2015.01.025
复制
发表时间：
2015-05-01
影响因子：
7
通讯作者：
Khan, Mohammad K.
中科院分区：
文献类型：
--
作者：
Jegadeesh, Naresh;Rajpara, Raj;Esiashvili, Natia;Shi, Zheng;Liu, Yuan;Okwan-Duodu, Derrick;Flowers, Christopher R.;Khan, Mohammad K.
在利妥昔单抗时代，III期和IV期DLBCL的巩固放射治疗(RT)的作用还没有很好的确定。有证据表明，一些患有大块头疾病的患者可能会受益，但患者选择标准还没有很好地确立。我们试图确定在单独接受基于利妥昔单抗的化疗后经历高局部失败率的患者的子集，因此可能受益于增加巩固的RT。本文回顾了1999年8月至2012年1月间收治的211例III、IV期DLBCL患者。在这些患者中，89人对包括利妥昔单抗在内的系统治疗完全有效，没有接受初始RT。进行Kaplan-Meier分析和Cox比例风险回归，以局部复发(LR)为主要结果。中位随访期为43.9个月。50%的患者在5年内经历了LR。在多变量分析中，肿瘤、≥、5 cm和III期疾病与LR风险增加相关。≥病变直径为5 cm的患者5年无LR生存率为47.4%，而病变直径为5 cm的患者为74.7%(P=0.0 1)。在5厘米肿瘤患者中，所有LR患者的SUVmax均为≥15。SUV<；15的5年无LR生存率为100%，而SUV≥15的无LR生存率为68.8%(p=0.10)。晚期弥漫性大B细胞淋巴瘤患者，如果是III期或疾病≥为5厘米的患者，发生LR的风险似乎增加。患有<lt；5 cm疾病和SUVmax≥15的患者患LR的风险较高。这些患者可能受益于化疗免疫治疗后的巩固RT。
The role of consolidative radiotherapy (RT) for stage III and IV DLBCL in the era of rituximab is not well defined. There is evidence that some patients with bulky disease may benefit, but patient selection criteria are not well established. We sought to identify a subset of patients who experienced a high local failure rate after receiving rituximab-based chemotherapy alone and hence may benefit from the addition of consolidative RT. 211 stage III and IV DLBCL patients treated between August 1999 and January 2012 were reviewed. Of these, 89 had a complete response to systemic therapy including rituximab and received no initial RT. Kaplan-Meier analysis and Cox proportional hazards regression were performed with local recurrence (LR) as the primary outcome. Median follow-up was 43.9 months. 50% experienced LR at 5 years. In multivariate analysis tumor ≥ 5 cm and stage III disease were associated with increased risk of LR. Five year LR free survival for patients with ≥ 5 cm lesions were 47.4% versus 74.7% for patients with < 5cm lesions (p = 0.01). In patients with < 5 cm tumors, SUVmax was ≥15 in all patients with LR. Five year LR free survival was 100% in SUV < 15 versus 68.8% in SUV≥15 (p=0.10). Advanced stage DLBCL patients who are stage III or with disease ≥ 5 cm appear to be at an increased risk for LR. Patients with < 5 cm disease and SUVmax≥15 may be at higher risk for LR. These patients may benefit from consolidative RT following chemoimmunotherapy.
登录
查看更多内容
影响因子：
158.5
作者：
Miller, TP;Dahlberg, S;Fisher, RI
通讯作者：
Fisher, RI
DOI：
10.1016/j.ijrobp.2011.12.067
发表时间：
2012-11-01
影响因子：
7
作者：
Dorth, Jennifer A.;Prosnitz, Leonard R.;Kelsey, Chris R.
通讯作者：
Kelsey, Chris R.
DOI：
10.1016/0360-3016(94)90352-2
发表时间：
1994-11-15
影响因子：
7
作者：
AVILES, A;DELGADO, S;DIAZMAQUEO, JC
通讯作者：
DIAZMAQUEO, JC
18F-氟脱氧葡萄糖正电子发射断层扫描的最大标准摄取值是新诊断的弥漫性大B细胞淋巴瘤患者无进展生存的预后因素。
影响因子：
3.5
作者：
Miyazaki, Yukihiro;Nawa, Yuichiro;Miyagawa, Masao;Kohashi, Sumiko;Nakase, Koichi;Yasukawa, Masaki;Hara, Masamichi
通讯作者：
Hara, Masamichi
DOI：
10.1200/jco.2009.27.3441
发表时间：
2010-09-20
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Phan, Jack;Mazloom, Ali;Dabaja, Bouthaina Shbib
通讯作者：
Dabaja, Bouthaina Shbib