TORNA ALL’ELENCO

Either combined-modality or radiotherapy alone provide favorable outcome in stage I-II mantle cell lymphoma: A report of 82 patients from the international lymphoma radiation oncology group (ILROG) in Blood

2013
AOU Città della Salute di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (13)Vedi tutti...

Dabaja BS

Tsang R

Qi S


et alii...

Abstract

Patients with Mantle cell lymphoma (MCL) often present with advanced-stage and have a poor prognosis. Although MCL is highly radiosensitive, RT is rarely used other than for palliation. Stage I-II presentation is rare, and there is only limited data on treatment outcome with less aggressive combined modality approaches or RT alone. To assess the outcome of this group of patients, we retrospectively reviewed 82 patients referred to radiation oncology at 9 ILROG institutions between 1990 and 2012. Of the 82 patients, 65 (79%) were males, 44 (54%) were > 60 years; 47 (57%) were stage I, 61 (74%) presented in the head and neck areas, 51 (62%) had extranodal presentation, 14 (17%) were bulky (>5 cm). Treatment approaches consisted of combined modality (CM) with chemotherapy and consolidative radiation therapy (RT) in 66 (80%) and definitive RT alone in 16 (20%). The median radiation dose used was 35 Gy (range 12-45). Chemotherapy consisted of cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP) or CHOP-like, regimens in 62 (57%), rituximab was added to chemotherapy in 51 (62%). The median follow-up was 60 months (range 5-245). At last follow up, 26 (32%) patients relapsed (70% of relapses were outside the radiation field) and 21 (26%) died (2 deaths unrelated to disease or treatment). The 5-and 10-years overall survivals (OS) were 71% and 63%, respectively. The 5-and 10-years disease free survivals (DFS) were 75% and 39%, respectively. On univariate analysis, the following characteristics were significantly associated with DFS and OS: age as a continuous variable (HR=1.05, p=0.005 for DFS; HR=1.05, p=0.006 for OS) and bulky disease (HR=2.78, p=0.03 for DFS; HR= 3.18, p=0.02 for OS). On multivariate analysis, both DFS and OS were significantly influenced by: age as a continuous variable (HR=2.09, p=0.03; HR=1.05, p=0.005), bulky disease (HR=2.23, p=0.05; HR=3.1, p=0.03), and female gender only affected DFS (HR=2.16, p=0.03). (Table Presented) Conclusion

Keywords

doxorubicin; cyclophosphamide; rituximab; prednisone; vincristine; mantle cell lymphoma; patient; human; lymphoma; oncology; society; hematology; radiotherapy; chemotherapy; follow up; radiation dose; male; relapse; overall survival; univariate analysis; neck; treatment outcome; palliative therapy; prognosis; disease control; radiation field; death; multivariate analysis; disease free survival; gender; survival; female;