利妥昔单抗时代放疗在60岁以上弥漫性大B细胞淋巴瘤患者中的作用。
The role of radiotherapy for patients over age 60 with diffuse large B-cell lymphoma in the rituximab era.
作者信息
Cassidy R J, Jegadeesh N, Switchenko J, Danish H, Esiashvili N, Flowers C R, Khan M K
机构信息
a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA ;
b Biostatistics Shared Core Resource, Winship Cancer Institute , Atlanta , GA , USA ;
出版信息
Leuk Lymphoma. 2016 Aug;57(8):1876-82. doi: 10.3109/10428194.2015.1120866. Epub 2016 Jan 12.
The role of consolidative radiotherapy (RT) in patients ≥60 years old with DLBCL in the rituximab era is controversial. We examined the impact on disease control and overall survival by the addition of consolidative RT after completion of chemotherapy, while adjusting for known adverse risk factors. Retrospective chart review from 2004 to 2012 of 83 consecutive patients ≥60 years old with DLBCL treated in the rituximab era, 68 of which had a complete response to chemotherapy, was performed. Amongst patients with a complete response, consolidative RT use was associated with 100% 5-year local control, improved progression-free survival (p = 0.047), and a trend for overall survival (p = .098) on multivariate analysis. Amongst all patients, the use of consolidative RT was associated with improved overall survival (p = 0.03). The use of consolidative RT should be considered for patients ≥60 years old independent of stage and response to chemotherapy.
在利妥昔单抗时代，巩固性放疗（RT）在年龄≥60岁的弥漫大B细胞淋巴瘤（DLBCL）患者中的作用存在争议。我们在调整已知不良风险因素的同时，研究了化疗完成后加用巩固性RT对疾病控制和总生存期的影响。对2004年至2012年在利妥昔单抗时代连续治疗的83例年龄≥60岁的DLBCL患者进行回顾性病历审查，其中68例对化疗有完全缓解。在完全缓解的患者中，多因素分析显示，使用巩固性RT与5年局部控制率100%、无进展生存期改善（p = 0.047）以及总生存期呈趋势性改善（p = 0.098）相关。在所有患者中，使用巩固性RT与总生存期改善相关（p = 0.03）。对于年龄≥60岁的患者，无论分期及对化疗的反应如何，均应考虑使用巩固性RT。
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