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- Title
Outcomes of Patients Treated With RCHOP With a PET-Adapted Approach for Consolidative Radiotherapy: A Retrospective Single-Center Study at the Royal Marsden Hospital.
- Authors
Su Li; Sharma, Bhupinder; Yusuf, Siraj; Michalarea, Vasiliki; Gleeson, Mary; Hickmott, Laura; Wotherspoon, Andrew; Attygalle, Ayoma D.; Vroobel, Katherine; O'Connor, Simon; Yong Du; Kuhnl, Andrea; Iyengar, Sunil; El-Sharkawi, Dima; Chau, Ian; Cunningham, David
- Abstract
Chemotherapy followed by consolidative mediastinal radiotherapy has been the standard treatment for primary mediastinal B cell lymphoma; however, there are long-term side effects associated with radiotherapy. We retrospectively reviewed outcomes of patients treated at our institution using a PET-guided approach that identified patients suitable for surveillance rather than radiotherapy following chemotherapy. Background: Treatment with CHOP-based chemotherapy with consolidative radiotherapy (CRT) for primary mediastinal B cell lymphoma (PMBCL) has been the standard approach in the pre-rituximab era. Overtreatment with CRT for patients who may have already been cured by primary immunochemotherapy in the rituximab era is a significant concern due to the long-term toxicity associated with radiotherapy. Positron emission tomography (PET) may help to identify patients who may not benefit from further CRT. Methods: We conducted a retrospective review of patients treated at the Royal Marsden Hospital between 2003 and 2020 for PMBCL to assess CRT use and survival outcomes. Results: Forty-three patients were identified, with 95% of the patients receiving R-CHOP. CRT was given in 5 patients. Five-year event-free survival was 79% (95% confidence interval: 64%-89%) and 5-year overall survival was 88% (95% confidence interval: 73%-95%). Seven of 9 patients with DS4 did not receive CRT and instead monitored with serial PET scans. None of these 7 patients relapsed in the mediastinum. Conclusion: CRT may be omitted in patients with a negative end of treatment PET scans; however, careful observation may also obviate the need for CRT in PET positive patients.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2024, Vol 24, Issue 1, p48
- ISSN
2152-2650
- Publication type
Article
- DOI
10.1016/j.clml.2023.08.021