Document Detail


Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone with or without radiotherapy in primary mediastinal large B-cell lymphoma: the emerging standard of care.
MedLine Citation:
PMID:  22282906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PATIENT AND METHODS: Seventy-six consecutive PMLBCL patients who received R-CHOP with or without radiotherapy (RT) were compared with 45 consecutive historical controls treated with CHOP with or without RT. Baseline characteristics of the two groups were balanced.
RESULTS: The rate of early treatment failure was much lower with R-CHOP with or without RT (9% versus 30%; p = .004). The 5-year freedom from progression rate after R-CHOP with or without RT was 81%, versus 48% for CHOP with or without RT (p < .0001). The 5-year event-free survival rates were 80% and 47% (p < .0001) and the 5-year overall and lymphoma-specific survival rates were 89% and 69% (p = .003) and 91% and 69% (p = .001), respectively, with only seven of 76 lymphoma-related deaths. Among R-CHOP responders, 52 of 68 received RT.
CONCLUSIONS: Based on these results, most patients with PMLBCL appear to be cured by R-CHOP in 21-day cycles with or without RT, which could be the current standard of care. Therefore, the need for more aggressive treatment strategies is questionable unless high-risk patients are adequately defined. Further studies are required to establish the precise role of RT.
Authors:
Theodoros P Vassilakopoulos; Gerassimos A Pangalis; Andreas Katsigiannis; Sotirios G Papageorgiou; Nikos Constantinou; Evangelos Terpos; Alexandra Zorbala; Effimia Vrakidou; Panagiotis Repoussis; Christos Poziopoulos; Zacharoula Galani; Maria N Dimopoulou; Stella I Kokoris; Sotirios Sachanas; Christina Kalpadakis; Evagelia M Dimitriadou; Marina P Siakantaris; Marie-Christine Kyrtsonis; John Dervenoulas; Meletios A Dimopoulos; John Meletis; Paraskevi Roussou; Panayiotis Panayiotidis; Photis Beris; Maria K Angelopoulou
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Publication Detail:
Type:  Journal Article     Date:  2012-01-26
Journal Detail:
Title:  The oncologist     Volume:  17     ISSN:  1549-490X     ISO Abbreviation:  Oncologist     Publication Date:  2012  
Date Detail:
Created Date:  2012-02-27     Completed Date:  2012-06-25     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  9607837     Medline TA:  Oncologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  239-49     Citation Subset:  IM    
Affiliation:
Department of Haematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens 11527, Greece. tvassilak@med.uoa.gr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antibodies, Monoclonal, Murine-Derived / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  therapeutic use*
Chemoradiotherapy
Cyclophosphamide / administration & dosage
Doxorubicin / administration & dosage
Female
Humans
Lymphoma, Large B-Cell, Diffuse / drug therapy*,  mortality,  radiotherapy
Male
Middle Aged
Positron-Emission Tomography and Computed Tomography
Prednisolone / administration & dosage
Vincristine / administration & dosage
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Murine-Derived; 0/rituximab; 23214-92-8/Doxorubicin; 50-18-0/Cyclophosphamide; 50-24-8/Prednisolone; 57-22-7/Vincristine
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