방사선종양학

  • [J Radiat Res.] A multi-institutional and case-matched control study on treatment outcomes of consolidative radiotherapy after a full course of R-CHOP compared with R-CHOP alone in Stage I-II diffuse large B-cell lymphoma (KROG 17-02).

    가톨릭대 / 정미주, 조원경, 이종훈*

  • 출처
    J Radiat Res.
  • 등재일
    2019 Oct 23
  • 저널이슈번호
    60(5):677-684. doi: 10.1093/jrr/rrz043.
  • 내용

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    Abstract
    We compared treatment outcomes between rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy alone with R-CHOP followed by consolidative radiation therapy (RT) in diffuse large B-cell lymphoma (DLBCL). We analyzed 404 patients with Stage I-II DLBCL who received six to eight cycles of R-CHOP and achieved a good response after a full course of chemotherapy. Propensity-score matching was used to assess the role of consolidative RT. The R-CHOP alone group (n = 184) was matched in a 1:2 ratio with the R-CHOP plus RT group (n = 92). Twenty-four (13.0%) of 184 patients receiving R-CHOP alone and 8 (8.7%) of 92 patients receiving R-CHOP plus RT had bulky diseases (>7.5 cm). A Deauville score of 1-2 was achieved for 159 (86.4%) of 184 patients receiving R-CHOP alone and 84 (91.3%) of 92 patients receiving R-CHOP plus RT. After a median follow-up time of 42 months, the recurrence-free survival (RFS) rate (86.7% vs 93.0%, P = 0.464) and overall survival rate (88.3% vs 95.1%, P = 0.295) at 5 years did not differ significantly between the R-CHOP alone and R-CHOP plus RT arms. In the additional multivariate analyses, large tumor size (>7.5 cm) was significantly associated with decreased RFS (hazard ratio, 2.368 and confidence interval, 1.837-6.697; P = 0.048). Consolidative radiation was not a significant factor for RFS (P = 0.563). Tumor size was a significant factor for RFS in the rituximab era. The outcome of omitting consolidative RT for good responders after six to eight cycles of R-CHOP chemotherapy was acceptable in early-stage DLBCL without a bulky disease.

     


    Author information

    Chung MJ1, Cho WK2, Oh D2, Eom KY3, Kim JH4, Kim WC5, Lee JH6.
    1
    Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
    2
    Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
    3
    Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea.
    4
    Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
    5
    Department of Radiation Oncology, Inha University Hospital, Inha University of Medicine, Inchon, Korea.
    6
    Department of Radiation Oncology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, 442-723, 93-6, Ji-dong, Paldal-gu, Suwon, Kyeonggi-do, Republic of Korea.

  • 키워드
    R-CHOP; consolidative radiation therapy; diffuse large B-cell lymphoma
  • 편집위원

    DLBCL환자에서 방사선의 치료효과와 적응대상을 조금 더 구체화한 연구라 흥미롭습니다.

    2020-01-03 15:44:03

  • 편집위원2

    R-CHOP alone과 full course간의 outcome 차이는 많은 관심을 가지 는 분야 B-cell lymphoma 에 대한 RT role에 대한 임상적 제안

    2020-01-03 15:56:11

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