title: Rituximab in treatment of primary gastric diffuse large B-cell lymphoma.
abstract: In the rituximab era, the optimal treatment modality for primary gastric diffuse large B-cell lymphoma (PG-DLBCL) still remains unclear. We performed a retrospective, multicenter analysis of 65 patients with PG-DLBCL to assess the efficacy and toxicity of the addition of rituximab to conventional chemotherapy. When compared with conventional chemotherapy, there was a trend that rituximab plus chemotherapy yielded a higher complete response rate, 5-year event-free survival (EFS) rate and 5-year overall survival (OS) rate, but this was not statistically significant. In subgroup analysis, better OS was observed only for patients with advanced-stage disease when rituximab was added. When involved-field radiotherapy (IFRT) was included, EFS and OS were significantly prolonged in the conventional chemotherapy group, but not in the immunochemotherapy group. If focusing on patients with localized-stage disease receiving immunochemotherapy, the efficacies of short-course rituximab (R)-chemotherapy plus IFRT and 6-8 courses of R-chemotherapy without IFRT were comparable. In conclusion, it is necessary to carry out prospective randomized trials to help further illuminate the role of rituximab in the PG-DLBCL treatment landscape. If a patient has been treated with a non-rituximab-containing regimen, additional IFRT should be considered, and for patients with advanced-stage disease, rituximab should be considered.
authors.affiliation: Department of Medical Oncology, Fudan University, Shanghai, China. syner2000@163.com
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Gang
authors.initials: G
authors.lastname: Li
authors.forename: Haiyan
authors.initials: H
authors.lastname: Yang
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Liu
authors.forename: Junning
authors.initials: J
authors.lastname: Cao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab