Role of radiation therapy in the management of primary mediastinal large B-cell lymphoma (PMLBL).
OBJECTIVE
PMLBL is a rare disease in Japan, and its optimal management and prognosis remain to be examined. A retrospective analysis of combined modality treatment in PMLBL was performed.


METHODS
Three women and four men (mean age, 36 years) were found to have PMLBL. Six patients had stage II disease, and one patient stage III disease. Each patient had a mediastinal tumor over 9 cm in diameter. The numbers of risk factors according to the international prognostic index (IPI) and modified tumor score (mTS) were 2 and 2 or 3, respectively. All patients were treated by doxorubicin-based chemotherapy. Two patients underwent tumor resection. Radiation therapy of 27.3 to 40 Gy (mean, 32 Gy) was delivered, after chemotherapy in six patients, and before chemotherapy in one.


RESULTS
Only one stage IIE patient recurred in the bilateral kidneys and had a fatal outcome. The remaining six patients remain disease-free at follow-up ranging from seven to 126 months. Positive accumulation of gallium scintigraphy after chemotherapy was converted to negative by radiation therapy.


CONCLUSIONS
The favorable prognosis of PMLBL was confirmed in this study. Radiation therapy should preferably be delivered to all patients with PMLBL after chemotherapy.
Itami
Jun
J
Department of Radiation Therapy and Oncology, International Medical Center of Japan, Shinjuku-ku.
Hara
Ryusuke
R
Komiyama
Takafumi
T
Kato
Daiki
D
Saito
Kiyoshi
K
D000328:Adult; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000532:radiotherapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000532:radiotherapy*; D008297:Male; D009367:Neoplasm Staging; D011882:Radiotherapy, High-Energy; D012307:Risk Factors