title: Rituximab plus a CHOP-like regimen, central nervous system prophylaxis, and contralateral testicular irradiation for localized primary testicular diffuse large B-cell lymphoma lead to prolonged progression-free survival.
abstract: We retrospectively evaluated the clinical features, management, and survival of 12 patients (age 51-84 years) with localized primary testicular diffuse large B-cell lymphoma (PTL). All 12 PTL patients underwent orchiectomy. Seven of the 12 patients were treated with strategy A, which consisted of at least six cycles of rituximab (R) plus a CHOP-like regimen, central nervous system (CNS) prophylaxis involving intrathecal chemotherapy (IT) and/or high-dose intravenous methotrexate, and contralateral scrotal irradiation (cRT). The other five patients were treated with strategy B, which included three regimens: orchiectomy alone, orchiectomy plus cRT and IT, and orchiectomy plus 3-4 cycles of R-CHOP plus cRT with or without IT. The median follow-up period was 48 months (range 19-123 months). The 4-year progression-free survival (PFS) rate for the seven patients treated with strategy A was 85.7 %, whereas that for the five patients treated with strategy B was 20 %. The patients treated with strategy A exhibited a significantly higher 4-year PFS rate than those treated with strategy B (P = 0.017). These results confirmed that the administration of a sufficient number of cycles of an R-containing chemotherapy regimen plus cRT plus CNS prophylaxis should be considered as a treatment for localized PTL.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan, kichika@juntendo.ac.jp.
authors.forename: Kunimoto
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Noguchi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Koike
authors.forename: Nanae
authors.initials: N
authors.lastname: Aritaka
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Sekiguchi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Sunami
authors.forename: Miyuki
authors.initials: M
authors.lastname: Tsutsui
authors.forename: Masaru
authors.initials: M
authors.lastname: Hosone
authors.forename: Takao
authors.initials: T
authors.lastname: Hirano
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gotoh
authors.forename: Norio
authors.initials: N
authors.lastname: Komatsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016543:Central Nervous System Neoplasms / Q000401:mortality / Q000473:pathology / Q000517:prevention & control / Q000556:secondary; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011878:Radiotherapy; D012189:Retrospective Studies; D000069283:Rituximab; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
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