PMID- 22252721
OWN - NLM
STAT- MEDLINE
DCOM- 20121024
LR  - 20191210
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Linking)
VI  - 118
IP  - 17
DP  - 2012 Sep 1
TI  - Limited-stage diffuse large B-cell lymphoma treated with abbreviated systemic 
      therapy and consolidation radiotherapy: involved-field versus involved-node 
      radiotherapy.
PG  - 4156-65
LID - 10.1002/cncr.26687 [doi]
AB  - BACKGROUND: For limited-stage diffuse large B-cell lymphoma (DLBCL), treatment 
      decisions are often influenced by toxicity profiles. One strategy that minimizes 
      chemotherapy-induced toxicities is abbreviated chemotherapy plus consolidation 
      involved-field radiotherapy (IFRT). Involved-node radiotherapy (INRT) is a new 
      concept to DLBCL, aimed to reduce radiotherapy-induced toxicities. We 
      retrospectively review the long-term outcomes of limited-stage DLBCL treated with 
      abbreviated systemic therapy and radiotherapy focusing on field size: IFRT versus 
      INRT. METHODS: The British Columbia Cancer Agency Lymphoid Cancer Database was 
      used to identify patients diagnosed with limited-stage DLBCL (stage I/II, without 
      B-symptoms; bulk < 10 cm) from 1981 to 2007. Patients were prescribed 3 cycles of 
      chemotherapy plus IFRT (1981-1996) or INRT</=5 cm (1996-2007), defined as INRT to 
      the prechemotherapy involved nodes with margins </= 5 cm. RESULTS: A total of 288 
      patients were identified: 56% were aged >60 years, 34% had stage II disease, 55% 
      had extranodal disease, 19% had elevated lactate dehydrogenase levels, and 15% 
      received rituximab. The two radiotherapy groups were IFRT (138 patients; 48%) and 
      INRT</=5cm (150 patients; 52%); median follow-up was 117 and 89 months, 
      respectively. Distant relapse was the most common site of failure in both groups. 
      After INRT</=5 cm, marginal recurrence was infrequent (2%). Time to progression (P 
      = .823), progression-free survival (P = .575), and overall survival (P = .417) 
      were not significantly different between the radiotherapy cohorts. Radiotherapy 
      field size was not a significant prognostic factor on multivariate analyses. 
      CONCLUSIONS: This research is the first known body of work to apply the concept 
      of INRT to limited-stage DLBCL. Reducing the field size from IFRT to INRT</=5 cm 
      maintains a low marginal recurrence risk with no impact on overall outcome.
CI  - Copyright (c) 2012 American Cancer Society.
FAU - Campbell, Belinda A
AU  - Campbell BA
AD  - Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer 
      Centre, Melbourne, Australia. Belinda.Campbell@petermac.org
FAU - Connors, Joseph M
AU  - Connors JM
FAU - Gascoyne, Randy D
AU  - Gascoyne RD
FAU - Morris, W James
AU  - Morris WJ
FAU - Pickles, Tom
AU  - Pickles T
FAU - Sehn, Laurie H
AU  - Sehn LH
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120117
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Combined Modality Therapy/adverse effects
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - *Lymphatic Irradiation
MH  - Lymphoma, Large B-Cell, Diffuse/*drug therapy/mortality/pathology/*radiotherapy
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
EDAT- 2012/01/19 06:00
MHDA- 2012/10/25 06:00
CRDT- 2012/01/19 06:00
PHST- 2011/06/01 00:00 [received]
PHST- 2011/08/08 00:00 [revised]
PHST- 2011/08/18 00:00 [accepted]
PHST- 2012/01/19 06:00 [entrez]
PHST- 2012/01/19 06:00 [pubmed]
PHST- 2012/10/25 06:00 [medline]
AID - 10.1002/cncr.26687 [doi]
PST - ppublish
SO  - Cancer. 2012 Sep 1;118(17):4156-65. doi: 10.1002/cncr.26687. Epub 2012 Jan 17.