A J Olszewski1, J J Castillo. 1. The Cancer Center at Memorial Hospital of Rhode Island, Pawtucket, RI 02860, USA. adam_olszewski@brown.edu
Abstract
BACKGROUND: Therapy for gastric marginal zone (MALT) lymphoma is largely based on single-arm trials. This observational study compared survival with radiotherapy, rituximab and combination chemoimmunotherapy in this disease. PATIENTS AND METHODS: Gastric MALT lymphoma cases diagnosed between 1997 and 2007 were selected from the Surveillance, Epidemiology and End Results-Medicare database. Propensity score analysis and competing risk models were used to compare survival in patients with stage IE treated with radiation or chemotherapy, and in patients of all stages treated with rituximab alone or with chemoimmunotherapy. RESULTS: Among 1134 patients, 21% underwent radiation and 24% chemotherapy as initial treatment. In the balanced cohort of 347 patients with stage IE, radiotherapy alone was associated with a better cause-specific survival [hazard ratio (HR) 0.27, P < 0.001]. Patients receiving systemic therapy had better survival if it incorporated rituximab (HR 0.53, P = 0.017). After adjustment for confounding, the outcomes of those who received rituximab alone or combination chemoimmunotherapy were not statistically different (P = 0.14). CONCLUSIONS: In elderly patients with stage IE gastric MALT lymphoma, radiotherapy was associated with lower risk of lymphoma-related death than chemotherapy. In those requiring systemic treatment, addition of cytotoxic chemotherapy to rituximab in the first-line regimen was not associated with improved survival.
BACKGROUND: Therapy for gastric marginal zone (MALT) lymphoma is largely based on single-arm trials. This observational study compared survival with radiotherapy, rituximab and combination chemoimmunotherapy in this disease. PATIENTS AND METHODS: Gastric MALT lymphoma cases diagnosed between 1997 and 2007 were selected from the Surveillance, Epidemiology and End Results-Medicare database. Propensity score analysis and competing risk models were used to compare survival in patients with stage IE treated with radiation or chemotherapy, and in patients of all stages treated with rituximab alone or with chemoimmunotherapy. RESULTS: Among 1134 patients, 21% underwent radiation and 24% chemotherapy as initial treatment. In the balanced cohort of 347 patients with stage IE, radiotherapy alone was associated with a better cause-specific survival [hazard ratio (HR) 0.27, P < 0.001]. Patients receiving systemic therapy had better survival if it incorporated rituximab (HR 0.53, P = 0.017). After adjustment for confounding, the outcomes of those who received rituximab alone or combination chemoimmunotherapy were not statistically different (P = 0.14). CONCLUSIONS: In elderly patients with stage IE gastric MALT lymphoma, radiotherapy was associated with lower risk of lymphoma-related death than chemotherapy. In those requiring systemic treatment, addition of cytotoxic chemotherapy to rituximab in the first-line regimen was not associated with improved survival.
Authors: A Ruskoné-Fourmestraux; W Fischbach; B M P Aleman; H Boot; M Q Du; F Megraud; C Montalban; M Raderer; A Savio; A Wotherspoon Journal: Gut Date: 2011-02-11 Impact factor: 23.059
Authors: Jennifer R Brown; Jonathan W Friedberg; Yang Feng; Sarah Scofield; Kimberly Phillips; Paola Dal Cin; Robin Joyce; Ronald W Takvorian; David C Fisher; Richard I Fisher; Jane Liesveld; Diana Marquis; Donna Neuberg; Arnold S Freedman Journal: Br J Haematol Date: 2009-03-30 Impact factor: 6.998
Authors: Antonio Salar; Eva Domingo-Domenech; Cristina Estany; Miguel A Canales; Fernando Gallardo; Octavio Servitje; Guadalupe Fraile; Carlos Montalbán Journal: Cancer Date: 2009-11-15 Impact factor: 6.860
Authors: Christina A Clarke; Sally L Glaser; Ronald F Dorfman; Paige M Bracci; Erin Eberle; Elizabeth A Holly Journal: Cancer Epidemiol Biomarkers Prev Date: 2004-01 Impact factor: 4.254
Authors: Barry W Hancock; Wendi Qian; David Linch; Jean-Charles Delchier; Paul Smith; Ira Jakupovic; Cathy Burton; Robert Souhami; Andrew Wotherspoon; Christiane Copie-Bergman; Carlo Capella; Catherine Traulle; Michael Levy; Sergio Cortelazzo; Andres J M Ferreri; Achille Ambrosetti; Graziella Pinotti; Giovanni Martinelli; Umberto Vitolo; Franco Cavalli; Christian Gisselbrecht; Emanuele Zucca Journal: Br J Haematol Date: 2008-11-22 Impact factor: 6.998