PURPOSE: To investigate the role of radiation therapy (RT) in patients affected with primary mediastinal B-cell lymphoma (PMBCL) with residual (18)fluorodeoxyglucose positron emission tomography ((18)FDG-PET)-positive disease after rituximab chemotherapy (R-CT). METHODS AND MATERIALS: Thirty-seven patients treated with R-CT and RT, all with (18)FDG-PET scan at diagnosis and before RT, were included. All (18)FDG-PET scans were reviewed, and responses were classified according to the Deauville 5-point scoring system. Outcomes measures were overall survival (OS) and progression-free survival (PFS), estimated for the whole cohort and for subgroups according to (18)FDG-PET score after R-CT. RESULTS: The median follow-up time was 40.9 months. Three patients were assigned to Deauville score 1 (8.1%), 9 to score 2 (24.3%), 7 to score 3 (19%), 14 to score 4 (37.8%), and 4 to score 5 (10.8%). After RT, all patients with score 3-4 experienced a complete response (CR). Among patients with score 5, 1 was in CR (25%), 2 had persistent positivity (50%), and 1 showed progressive disease (25%). A total of 4 patients experienced progression or relapse: 1 of 33 (3%) with scores 1-4, and 3 of 4 (75%) with score 5. The 3-year OS and PFS of the whole cohort were 89.8% and 88.7%, respectively. OS was significantly different between scores 1-3 and scores 4-5 (100% vs 77% at 3 years, P<.05). Patients with a score of 5 had a significantly worse outcome than did all other patients (OS at 2 years, 33.3% vs 100%). CONCLUSIONS: Approximately 50% of PMBCL patients show residual disease at (18)FDG-PET scan after R-CT. RT is able to convert to CR approximately 85% of these patients, but those with a Deauville score of 5 (10%) appear at high risk of progression and death, and they might be candidates for intensified programs.
PURPOSE: To investigate the role of radiation therapy (RT) in patients affected with primary mediastinal B-cell lymphoma (PMBCL) with residual (18)fluorodeoxyglucose positron emission tomography ((18)FDG-PET)-positive disease after rituximab chemotherapy (R-CT). METHODS AND MATERIALS: Thirty-seven patients treated with R-CT and RT, all with (18)FDG-PET scan at diagnosis and before RT, were included. All (18)FDG-PET scans were reviewed, and responses were classified according to the Deauville 5-point scoring system. Outcomes measures were overall survival (OS) and progression-free survival (PFS), estimated for the whole cohort and for subgroups according to (18)FDG-PET score after R-CT. RESULTS: The median follow-up time was 40.9 months. Three patients were assigned to Deauville score 1 (8.1%), 9 to score 2 (24.3%), 7 to score 3 (19%), 14 to score 4 (37.8%), and 4 to score 5 (10.8%). After RT, all patients with score 3-4 experienced a complete response (CR). Among patients with score 5, 1 was in CR (25%), 2 had persistent positivity (50%), and 1 showed progressive disease (25%). A total of 4 patients experienced progression or relapse: 1 of 33 (3%) with scores 1-4, and 3 of 4 (75%) with score 5. The 3-year OS and PFS of the whole cohort were 89.8% and 88.7%, respectively. OS was significantly different between scores 1-3 and scores 4-5 (100% vs 77% at 3 years, P<.05). Patients with a score of 5 had a significantly worse outcome than did all other patients (OS at 2 years, 33.3% vs 100%). CONCLUSIONS: Approximately 50% of PMBCL patients show residual disease at (18)FDG-PET scan after R-CT. RT is able to convert to CR approximately 85% of these patients, but those with a Deauville score of 5 (10%) appear at high risk of progression and death, and they might be candidates for intensified programs.
Authors: T P Vassilakopoulos; G A Pangalis; S Chatziioannou; S Papageorgiou; M K Angelopoulou; Z Galani; G Kourti; V Prassopoulos; T Leonidopoulou; E Terpos; M N Dimopoulou; S Sachanas; C Kalpadakis; P Konstantinidou; D Boutsis; E Stefanoudaki; L Kyriazopoulou; M P Siakantaris; M-C Kyrtsonis; E Variami; I Kotsianidis; A Symeonidis; E Michali; E Katodritou; G Kokkini; C Tsatalas; H Papadaki; M-A Dimopoulos; V Sotiropoulos; V Pappa; T Karmiris; J Meletis; J Apostolidis; I Datseris; P Panayiotidis; K Konstantopoulos; P Roussou; P Rondogianni Journal: Leukemia Date: 2015-05-14 Impact factor: 11.528
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