title: Early-stage primary bone lymphoma: a retrospective, multicenter Rare Cancer Network (RCN) Study.
abstract: OBJECTIVE
  Primary bone lymphoma (PBL) represents less than 1% of all malignant lymphomas. In this study, we assessed the disease profile, outcome, and prognostic factors in patients with Stages I and II PBL.
  
  
  METHODS
  Thirteen Rare Cancer Network (RCN) institutions enrolled 116 consecutive patients with PBL treated between 1987 and 2008 in this study. Eighty-seven patients underwent chemoradiotherapy (CXRT) without (78) or with (9) surgery, 15 radiotherapy (RT) without (13) or with (2) surgery, and 14 chemotherapy (CXT) without (9) or with (5) surgery. Median RT dose was 40 Gy (range, 4-60). The median number of CXT cycles was six (range, 2-8). Median follow-up was 41 months (range, 6-242).
  
  
  RESULTS
  The overall response rate at the end of treatment was 91% (complete response [CR] 74%, partial response [PR] 17%). Local recurrence or progression was observed in 12 (10%) patients and systemic recurrence in 17 (15%). The 5-year overall survival (OS), lymphoma-specific survival (LSS), and local control (LC) were 76%, 78%, and 92%, respectively. In univariate analyses (log-rank test), favorable prognostic factors for OS and LSS were International Prognostic Index (IPI) score ≤1 (p = 0.009), high-grade histology (p = 0.04), CXRT (p = 0.05), CXT (p = 0.0004), CR (p < 0.0001), and RT dose >40 Gy (p = 0.005). For LC, only CR and Stage I were favorable factors. In multivariate analysis, IPI score, RT dose, CR, and CXT were independently influencing the outcome (OS and LSS). CR was the only predicting factor for LC.
  
  
  CONCLUSIONS
  This large multicenter retrospective study confirms the good prognosis of early-stage PBL treated with combined CXRT. An adequate dose of RT and complete CXT regime were associated with better outcome.
authors.affiliation: Centre Hospitalier Universitaire Vaudois, Lausanne, VD, Switzerland.
authors.forename: Ling
authors.initials: L
authors.lastname: Cai
authors.forename: Michael C
authors.initials: MC
authors.lastname: Stauder
authors.forename: Yu-Jing
authors.initials: YJ
authors.lastname: Zhang
authors.forename: Philip
authors.initials: P
authors.lastname: Poortmans
authors.forename: Ye-Xiong
authors.initials: YX
authors.lastname: Li
authors.forename: Nicolaos
authors.initials: N
authors.lastname: Constantinou
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.forename: Sidney P
authors.initials: SP
authors.lastname: Kadish
authors.forename: Tan Dat
authors.initials: TD
authors.lastname: Nguyen
authors.forename: Youlia M
authors.initials: YM
authors.lastname: Kirova
authors.forename: Pirus
authors.initials: P
authors.lastname: Ghadjar
authors.forename: Damien C
authors.initials: DC
authors.lastname: Weber
authors.forename: Victoria Tuset
authors.initials: VT
authors.lastname: Bertran
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ozsahin
authors.forename: René-Olivier
authors.initials: RO
authors.lastname: Mirimanoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D003520:Cyclophosphamide / Q000008:administration & dosage; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011241:Prednisone / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D035583:Rare Diseases / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D000069283:Rituximab; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone