PURPOSE: To report the clinical findings and long-term results of front-line, third-generation MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin) chemotherapy and mediastinal involved-field radiotherapy (IFRT) in 85 consecutive, previously untreated patients with primary mediastinal large B cell lymphoma (PMLBCL) diagnosed and managed at a single institution. METHODS AND MATERIALS: Between 1991 and April 2004, 92 consecutive, untreated patients with PMLBCL were treated at our institution. The median age was 33 years (range, 15-61 years), 46 patients (50%) showed a mediastinal syndrome at onset; 52 patients (57%) showed a low/low-intermediate (0 to 1) and 40 patients (43%) an intermediate-high/high (2 to 3) International Prognostic Index (IPI) score. Eighty-five patients were treated with standard chemotherapy (MACOP-B), and 80 underwent mediastinal IFRT at a dose of 30-36 Gy. RESULTS: After a MACOP-B regimen, the overall response rate was 87% and the partial response rate 9%. After chemotherapy, (67)Ga scintigraphy/positron emission tomography results were positive in 43 of 52 patients (83%), whereas after IFRT 11 of 52 patients (21%) remained positive (p < 0.0001). After a median follow-up of 81 months (range, 2-196 months), progression or relapse was observed in 15 of 84 patients (18%). The projected 5-year overall survival and progression-free survival rates were 87% and 81%, respectively. The 5-year overall survival and progression-free survival rates were better for patients with an IPI of 0 to 1 than for those with an IPI of 2 to 3 (96% vs. 73% [p = 0.002] and 90% vs. 67% [p = 0.007], respectively). CONCLUSIONS: Combined-modality treatment with intensive chemotherapy plus mediastinal IFRT induces high response and lymphoma-free survival rates. Involved-field RT plays an important role in inducing negative results on (67)Ga scintigraphy/positron emission tomography in patients responsive to chemotherapy.
PURPOSE: To report the clinical findings and long-term results of front-line, third-generation MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin) chemotherapy and mediastinal involved-field radiotherapy (IFRT) in 85 consecutive, previously untreated patients with primary mediastinal large B cell lymphoma (PMLBCL) diagnosed and managed at a single institution. METHODS AND MATERIALS: Between 1991 and April 2004, 92 consecutive, untreated patients with PMLBCL were treated at our institution. The median age was 33 years (range, 15-61 years), 46 patients (50%) showed a mediastinal syndrome at onset; 52 patients (57%) showed a low/low-intermediate (0 to 1) and 40 patients (43%) an intermediate-high/high (2 to 3) International Prognostic Index (IPI) score. Eighty-five patients were treated with standard chemotherapy (MACOP-B), and 80 underwent mediastinal IFRT at a dose of 30-36 Gy. RESULTS: After a MACOP-B regimen, the overall response rate was 87% and the partial response rate 9%. After chemotherapy, (67)Ga scintigraphy/positron emission tomography results were positive in 43 of 52 patients (83%), whereas after IFRT 11 of 52 patients (21%) remained positive (p < 0.0001). After a median follow-up of 81 months (range, 2-196 months), progression or relapse was observed in 15 of 84 patients (18%). The projected 5-year overall survival and progression-free survival rates were 87% and 81%, respectively. The 5-year overall survival and progression-free survival rates were better for patients with an IPI of 0 to 1 than for those with an IPI of 2 to 3 (96% vs. 73% [p = 0.002] and 90% vs. 67% [p = 0.007], respectively). CONCLUSIONS: Combined-modality treatment with intensive chemotherapy plus mediastinal IFRT induces high response and lymphoma-free survival rates. Involved-field RT plays an important role in inducing negative results on (67)Ga scintigraphy/positron emission tomography in patients responsive to chemotherapy.
Authors: Vitaliana DE Sanctis; Alice DI Rocco; Maria Christina Cox; Maurizio Valeriani; Francesca Perrone Congedi; Dimitri Anzellini; Maria Massaro; Gianluca Vullo; Giuseppe Facondo; Flavia DE Giacomo; Marco Alfò; Daniela Prosperi; Patrizia Pizzichini; Sabrina Pelliccia; Agostino Tafuri; Maurizio Martelli; Mattia Falchetto Osti Journal: In Vivo Date: 2020 May-Jun Impact factor: 2.155
Authors: Chelsea C Pinnix; Bouthaina Dabaja; Mohamed Amin Ahmed; Hubert H Chuang; Colleen Costelloe; Christine F Wogan; Valerie Reed; Jorge E Romaguera; Sattva Neelapu; Yasuhiro Oki; M Alma Rodriguez; Luis Fayad; Frederick B Hagemeister; Loretta Nastoupil; Francesco Turturro; Nathan Fowler; Michelle A Fanale; Yago Nieto; Issa F Khouri; Sairah Ahmed; L Jeffrey Medeiros; Richard Eric Davis; Jason Westin Journal: Int J Radiat Oncol Biol Phys Date: 2015-05-01 Impact factor: 7.038
Authors: Chelsea C Pinnix; Andrea K Ng; Bouthaina S Dabaja; Sarah A Milgrom; Jillian R Gunther; C David Fuller; Grace L Smith; Zeinab Abou Yehia; Wei Qiao; Christine F Wogan; Mani Akhtari; Osama Mawlawi; L Jeffrey Medeiros; Hubert H Chuang; William Martin-Doyle; Philippe Armand; Ann S LaCasce; Yasuhiro Oki; Michelle Fanale; Jason Westin; Sattva Neelapu; Loretta Nastoupil Journal: Blood Adv Date: 2018-06-12