title: Rituximab-including combined modality treatment for primary thyroid lymphoma: an effective regimen for elderly patients.
abstract: BACKGROUND
  Primary thyroid lymphoma (PTL) develops mostly in middle-aged and older females. However, the optimal treatment for elderly patients with diffuse large B-cell lymphoma (DLBCL), which accounts for most PTL cases, is unclear. Rituximab is a promising drug that, in combination with traditional combination therapy, has demonstrated an increased antitumor effect without a substantial increase in toxicity. In this study, treatment outcomes of elderly patients with thyroid DLBCL who underwent rituximab-including combination therapy were analyzed.
  
  
  METHODS
  Between January 2005 and December 2011, 43 patients 60 years of age or older (median 71 years, range 60-80 years) were diagnosed as having stage IE (n=12) or stage IIE (n=31) DLBCL, and three courses of R-CHOP therapy (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, adriamycin 40 mg/m2, vincristine 1.4 mg/m2, and prednisolone 100 mg/body) and involved field irradiation were planned. Treatment outcomes of these patients were retrospectively reviewed.
  
  
  RESULTS
  Two patients terminated the treatment because of interstitial pneumonia during R-CHOP therapy. Only one patient showed treatment resistance and the regimen was changed; 42 patients (98%) responded to the treatment. Five-year overall survival and event-free survival were 87% (95% confidence interval [95% CI], 64-96%) and 74% (95% CI, 50-89%), respectively.
  
  
  CONCLUSIONS
  The results of the present study indicate that rituximab-including combination therapy was effective for elderly patients with thyroid DLBCL. A multicenter, long-term observational study is needed to confirm this, and additional refinement of the treatment protocol is required to optimize the antitumor effect.
authors.affiliation: 1 Ito Hospital , Tokyo, Japan .
authors.forename: Natsuko
authors.initials: N
authors.lastname: Watanabe
authors.forename: Hiroto
authors.initials: H
authors.lastname: Narimatsu
authors.forename: Jaeduk Yoshimura
authors.initials: JY
authors.lastname: Noh
authors.forename: Yo
authors.initials: Y
authors.lastname: Kunii
authors.forename: Koji
authors.initials: K
authors.lastname: Mukasa
authors.forename: Masako
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Miho
authors.initials: M
authors.lastname: Suzuki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sekiya
authors.forename: Hidemi
authors.initials: H
authors.lastname: Ohye
authors.forename: Ai
authors.initials: A
authors.lastname: Yoshihara
authors.forename: Kenji
authors.initials: K
authors.lastname: Iwaku
authors.forename: Sakiko
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Kaori
authors.initials: K
authors.lastname: Kameyama
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Nishikawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.forename: Kiminori
authors.initials: K
authors.lastname: Sugino
authors.forename: Koichi
authors.initials: K
authors.lastname: Ito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab; D013964:Thyroid Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab