Radiotherapy with rituximab may be better than radiotherapy alone in first-line treatment of early-stage follicular lymphoma: is it time to change the standard strategy?

被引:22
作者
Janikova, Andrea [1 ,2 ]
Bortlicek, Zbynek [3 ,4 ]
Campr, Vit [5 ,6 ]
Kopalova, Natasa [1 ,2 ]
Benesova, Katerina [7 ]
Belada, David [8 ]
Prochazka, Vit [9 ]
Pytlik, Robert [7 ]
Vokurka, Samuel [10 ,11 ]
Pirnos, Jan [12 ]
Duras, Juraj [13 ]
Mocikova, Heidi [14 ]
Mayer, Jiri [1 ,2 ]
Trneny, Marek [7 ]
机构
[1] Masaryk Univ, Dept Internal Med Hematol & Oncol, Jihlavska 20, Brno 62500, Czech Republic
[2] Univ Hosp Brno, Brno 62500, Czech Republic
[3] Masaryk Univ, Fac Med, Inst Biostat & Anal, Brno 62500, Czech Republic
[4] Masaryk Univ, Fac Sci, Brno 62500, Czech Republic
[5] Charles Univ Prague, Fac Med 2, Dept Pathol & Mol Med, Prague, Czech Republic
[6] Fac Hosp Motol, Prague, Czech Republic
[7] Charles Univ Prague, Gen Hosp, Dept Med 1, Prague, Czech Republic
[8] Univ Hosp Hradec Kralove, Dept Clin Hematol, Hradec Kralove, Czech Republic
[9] Univ Hosp Olomouc, Dept Hematol, Olomouc, Czech Republic
[10] Charles Univ Prague, Dept Hematooncol, Plzen, Czech Republic
[11] Univ Hosp Plzen, Plzen, Czech Republic
[12] Hosp Ceske Budejovice, Dept Oncol, Ceske Budejovice, Czech Republic
[13] Teaching Hosp Ostrava, Dept Clin Hematol, Ostrava, Czech Republic
[14] Univ Hosp Kralovske Vinohrady, Dept Hematol, Prague, Czech Republic
关键词
Follicular lymphoma; rituximab; radiotherapy; NON-HODGKINS-LYMPHOMA; TERM-FOLLOW-UP; POSITRON-EMISSION-TOMOGRAPHY; INVOLVED FIELD RADIOTHERAPY; LOW-GRADE; RADIATION-THERAPY; CELLS; MANAGEMENT; TRANSLOCATION; SURVIVAL;
D O I
10.3109/10428194.2014.990010
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Early-stage follicular lymphoma (FL) has traditionally been treated with involved-field radiotherapy (RT). Rituximab (R) is a low-toxic, efficient systemic therapy for FL, but there are no data about its clinical impact in early FL. We retrospectively analyzed 93 patients with stage I-II indolent FL treated with RT (n = 65) or RT + R (n = 14) or R alone (n = 14). Median follow-up was 5.0 years for patients with RT, 2.8 years for the RT + R subgroup and 2.5 years for patients treated with R. The complete response rate was 92%, 100% and 86% (not significant) and the median PFS was 3.3 years, not reached and 4.9 years (p = 0.035) for the RT, RT + R and R arms, with no impact on overall survival. R combined with RT seems to give better results in terms of global FL control, but longer follow-up and prospective comparison are needed to verify these results.
引用
收藏
页码:2350 / 2356
页数:7
相关论文
共 35 条
[11]  
Ghielmini M, 2013, ANN ONCOL, V24, P561, DOI [10.1093/annonc/mds517, 10.1093/annonc/mdr388]
[12]   Rituximab in the treatment of non-Hodgkin's lymphoma - a critical evaluation of randomized controlled trials [J].
Griffin, Morag Meriel ;
Morley, Nick .
EXPERT OPINION ON BIOLOGICAL THERAPY, 2013, 13 (05) :803-811
[13]   Long-term outcome and mortality trends in early-stage, Grade 1-2 follicular lymphoma treated with radiation therapy [J].
Guadagnolo, BA ;
Li, SG ;
Neuberg, D ;
Ng, A ;
Hua, L ;
Silver, B ;
Stevenson, MA ;
Mauch, P .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2006, 64 (03) :928-934
[14]   High response rates and lasting remissions after low-dose involved field radiotherapy in indolent lymphomas [J].
Haas, RLM ;
Poortmans, P ;
de Jong, D ;
Aleman, BMP ;
Dewit, LGH ;
Verheij, M ;
Hart, AAM ;
van Oers, MHJ ;
van der Hulst, M ;
Baars, JW ;
Bartelink, H .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (13) :2474-2480
[15]   CLINICAL STAGE-1 NON-HODGKINS-LYMPHOMA - LONG-TERM FOLLOW-UP OF PATIENTS TREATED BY THE BRITISH NATIONAL LYMPHOMA INVESTIGATION WITH RADIOTHERAPY ALONE AS INITIAL THERAPY [J].
HUDSON, BV ;
HUDSON, GV ;
MACLENNAN, KA ;
ANDERSON, L ;
LINCH, DC .
BRITISH JOURNAL OF CANCER, 1994, 69 (06) :1088-1093
[16]   Value of [18F]fluorodeoxyglucose positron emission tomography in the management of follicular lymphoma:: The end of a dilemma? [J].
Janikova, Andrea ;
Bolcak, Karol ;
Pavlik, Tomas ;
Mayer, Jiri ;
Kral, Zdenek .
CLINICAL LYMPHOMA & MYELOMA, 2008, 8 (05) :287-293
[17]   A real-time (PCR) for a real life ...? Quantitative evaluation of BCL2/IGH in follicular lymphoma and its implications for clinical practice [J].
Janikova, Andrea ;
Mareckova, Andrea ;
Dvorakova, Dana ;
Bortlicek, Zbynek ;
Tichy, Boris ;
Navratil, Milan ;
Kral, Zdenek ;
Pospisilova, Sarka ;
Mayer, Jiri .
EXPERIMENTAL HEMATOLOGY, 2012, 40 (07) :528-539
[18]   A BRITISH-NATIONAL-LYMPHOMA-INVESTIGATION RANDOMIZED TRIAL OF SINGLE-AGENT CHLORAMBUCIL PLUS RADIOTHERAPY VERSUS RADIOTHERAPY ALONE IN LOW-GRADE, LOCALIZED NON-HODGKINS-LYMPHOMA [J].
KELSEY, SM ;
NEWLAND, AC ;
HUDSON, GV ;
JELLIFFE, AM .
MEDICAL ONCOLOGY, 1994, 11 (01) :19-25
[19]   Reduced dose radiotherapy for local control in non-Hodgkin lymphoma: A randomised phase III trial [J].
Lowry, Lisa ;
Smith, Paul ;
Qian, Wendi ;
Falk, Stephen ;
Benstead, Kim ;
Illidge, Tim ;
Linch, David ;
Robinson, Martin ;
Jack, Andrew ;
Hoskin, Peter .
RADIOTHERAPY AND ONCOLOGY, 2011, 100 (01) :86-92
[20]   Is radiotherapy curative for stage I and II low-grade follicular lymphoma? Results of a long-term follow-up study of patients treated at Stanford University [J].
MacManus, MP ;
Hoppe, RT .
JOURNAL OF CLINICAL ONCOLOGY, 1996, 14 (04) :1282-1290