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The role of local radiotherapy following rituximab‐containing chemotherapy in patients with transformed indolent B‐cell lymphoma
Author(s) -
Nozaki Kenji,
Maruyama Dai,
Maeshima Akiko Miyagi,
Tajima Kinuko,
Itami Jun,
Shichijo Takafumi,
Yuda Sayako,
Suzuki Tomotaka,
Toyoda Kosuke,
Yamauchi Nobuhiko,
Makita Shinichi,
Fukuhara Suguru,
Munakata Wataru,
Kobayashi Yukio,
Taniguchi Hirokazu,
Izutsu Koji,
Tobinai Kensei
Publication year - 2021
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13539
Subject(s) - medicine , rituximab , hazard ratio , chemotherapy , oncology , gastroenterology , confidence interval , radiation therapy , stage (stratigraphy) , lymphoma , surgery , paleontology , biology
Objectives This study aimed to evaluate the outcomes of local radiotherapy (LRT) in patients with histologic transformation (HT) following rituximab‐containing chemotherapy. Methods We retrospectively analysed 92 patients with biopsy‐confirmed HT undergoing rituximab‐containing chemotherapy at our institution between 2003 and 2015. Results Of the 36 patients with limited‐stage disease at diagnosis of HT, 29 (78%) received LRT. The estimated 5‐year progression‐free survival (PFS) rate was significantly better in patients who underwent LRT than in those who did not (93% and 42%, respectively; P < 0.05). Multivariate analyses employing age, sex, performance status, LRT and treatment response demonstrated that LRT was an independent prognostic factor for PFS (hazard ratio [HR]: 11.8; 95% confidence interval [CI]: 1.28‐108.1; P < 0.05). Of the 32 patients who underwent LRT for HT lesion treatment, 31 (97%) did not show disease progression within radiation fields; among them, 27 patients (84%) survived without disease progression during the follow‐up period. One patient developed hypothyroidism due to LRT; the others had no acute or late‐onset complications of LRT. Conclusions Our data support the recommendation of LRT for HT lesion treatment following rituximab‐containing chemotherapy in select patients with localised HT, as a rational treatment approach with potentially limited toxicity.