The role of radiotherapy for patients over age 60 with diffuse large B-cell lymphoma in the rituximab era

• Published in: Leukemia & lymphoma Vol. 57; no. 8; pp. 1876 - 1882
• Main Authors: Cassidy, R. J., Jegadeesh, N., Switchenko, J., Danish, H., Esiashvili, N., Flowers, C. R., Khan, M. K.
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 02-08-2016
• Subjects: Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone Marrow - pathology; Cyclophosphamide - adverse effects; Cyclophosphamide - therapeutic use; diffuse large B-cell lymphoma (DLBCL); Disease-Free Survival; Doxorubicin - adverse effects; Doxorubicin - therapeutic use; Elderly; Female; Humans; Kaplan-Meier Estimate; Lymph Nodes - pathology; Lymphoma, Large B-Cell, Diffuse - mortality; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Large B-Cell, Diffuse - therapy; Male; Middle Aged; Neoplasm Staging; Prednisone - adverse effects; Prednisone - therapeutic use; radiotherapy; Radiotherapy, Adjuvant - adverse effects; Retrospective Studies; Risk Factors; Rituximab - therapeutic use; Treatment Outcome; Vincristine - adverse effects; Vincristine - therapeutic use; radiotherapy; diffuse large B-cell lymphoma (DLBCL); Elderly
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428194.2015.1120866

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.