Facondo Giuseppe, Serio Mattia, Vullo Gianluca, Bianchi Maria Paola, Pelliccia Sabrina, Di Rocco Alice, Lanzolla Tiziana, Valeriani Maurizio, Di Napoli Arianna, Tafuri Agostino, Martelli Maurizio, Osti Mattia Falchetto, De Sanctis Vitaliana
Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, 00189 Rome, Italy.
Hematology Institute, Sapienza University of Rome, St. Andrea Hospital, 00189 Rome, Italy.
J Clin Med. 2023 May 31;12(11):3777. doi: 10.3390/jcm12113777.
In order to evaluate the efficacy of residual site radiation therapy (RSRT) in terms of progression-free survival (PFS) and overall survival (OS) in patients with primary mediastinal lymphoma (PMBCL) with Deauville Score 4 (DS 4) following rituximab and chemotherapy treatment (R-ICHT).
Thirty-one patients with PMBCL were recruited. After completion of R-ICHT, patients were staged with 18F-fluorodeoxyglucose positron-emission tomography, showing DS 4, and were treated with adjuvant RSRT. The chosen techniques for RT delivery were intensity-modulated radiation therapy (IMRT) or three-dimensional conformal RT (3D-CRT). Most patients underwent the first one using cone-beam computed tomography (CBCT). All patients were evaluated every 3 months for the first 2 years and every 6 months afterwards for a period of at least 5 years, with clinical and radiological procedures as required.
All patients received RSRT with a dose of 30 Gy in 15 fractions. The median follow-up time of 52.7 months (IQR: 26-64.1 months). The 5-year OS rate was 100%. The 2-year and 5-year PFS rates were 96.7% and 92.5%, respectively. Patients with relapsed disease had been treated with high-dose chemotherapy (HDC) and autologous stem cell transplantation (auto-SCT).
RSRT in patients with PMBCL treated with ICHT and DS 4 did not impact unfavorably on patient survival.
为了评估残留部位放射治疗（RSRT）对接受利妥昔单抗和化疗（R-ICHT）后Deauville评分4（DS 4）的原发性纵隔淋巴瘤（PMBCL）患者的无进展生存期（PFS）和总生存期（OS）的疗效。
招募了31例PMBCL患者。在完成R-ICHT后，患者接受18F-氟脱氧葡萄糖正电子发射断层扫描进行分期，显示为DS 4，并接受辅助性RSRT治疗。所选的放疗技术为调强放射治疗（IMRT）或三维适形放疗（3D-CRT）。大多数患者使用锥形束计算机断层扫描（CBCT）进行第一种治疗。所有患者在最初2年每3个月评估一次，之后每6个月评估一次，为期至少5年，并根据需要进行临床和放射学检查。
所有患者均接受了30 Gy、分15次的RSRT治疗。中位随访时间为52.7个月（四分位间距：26 - 64.1个月）。5年总生存率为100%。2年和5年无进展生存率分别为96.7%和92.5%。复发患者接受了大剂量化疗（HDC）和自体干细胞移植（auto-SCT）。
对于接受ICHT治疗且DS 4的PMBCL患者，RSRT对患者生存没有不利影响。
