title: Radiotherapy with rituximab may be better than radiotherapy alone in first-line treatment of early-stage follicular lymphoma: is it time to change the standard strategy?
abstract: Early-stage follicular lymphoma (FL) has traditionally been treated with involved-field radiotherapy (RT). Rituximab (R) is a low-toxic, efficient systemic therapy for FL, but there are no data about its clinical impact in early FL. We retrospectively analyzed 93 patients with stage I-II indolent FL treated with RT (n=65) or RT+R (n=14) or R alone (n=14). Median follow-up was 5.0 years for patients with RT, 2.8 years for the RT+R subgroup and 2.5 years for patients treated with R. The complete response rate was 92%, 100% and 86% (not significant) and the median PFS was 3.3 years, not reached and 4.9 years (p=0.035) for the RT, RT+R and R arms, with no impact on overall survival. R combined with RT seems to give better results in terms of global FL control, but longer follow-up and prospective comparison are needed to verify these results.
authors.affiliation: a Department of Internal Medicine - Hematology and Oncology , Masaryk University and University Hospital Brno , Brno , Czech Republic.
authors.forename: Andrea
authors.initials: A
authors.lastname: Janikova
authors.affiliation: b Institute of Biostatistics and Analyses, Faculty of Medicine and Faculty of Science, Masaryk University , Brno , Czech Republic.
authors.forename: Zbynek
authors.initials: Z
authors.lastname: Bortlicek
authors.affiliation: c Department of Pathology and Molecular Medicine , 2nd Faculty of Medicine, Charles University and Faculty Hospital in Motol , Prague , Czech Republic.
authors.forename: Vit
authors.initials: V
authors.lastname: Campr
authors.affiliation: a Department of Internal Medicine - Hematology and Oncology , Masaryk University and University Hospital Brno , Brno , Czech Republic.
authors.forename: Natasa
authors.initials: N
authors.lastname: Kopalova
authors.affiliation: d 1st Department of Medicine , Charles University General Hospital , Prague , Czech Republic.
authors.forename: Katerina
authors.initials: K
authors.lastname: Benesova
authors.affiliation: e Department of Clinical Hematology , University Hospital Hradec Kralove , Hradec Kralove , Czech Republic.
authors.forename: David
authors.initials: D
authors.lastname: Belada
authors.affiliation: f Department of Hematology , University Hospital Olomouc , Olomouc , Czech Republic.
authors.forename: Vit
authors.initials: V
authors.lastname: Prochazka
authors.affiliation: d 1st Department of Medicine , Charles University General Hospital , Prague , Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Pytlik
authors.affiliation: g Department of Hematooncology , Charles University and University Hospital Pilsen , Pilsen , Czech Republic.
authors.forename: Samuel
authors.initials: S
authors.lastname: Vokurka
authors.affiliation: h Department of Oncology , Hospital Ceske Budejovice , Ceske Budejovice , Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Pirnos
authors.affiliation: i Department of Clinical Hematology , Teaching Hospital Ostrava , Ostrava , Czech Republic.
authors.forename: Juraj
authors.initials: J
authors.lastname: Duras
authors.affiliation: j Department of Hematology , University Hospital Kralovske Vinohrady , Prague , Czech Republic.
authors.forename: Heidi
authors.initials: H
authors.lastname: Mocikova
authors.affiliation: a Department of Internal Medicine - Hematology and Oncology , Masaryk University and University Hospital Brno , Brno , Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Mayer
authors.affiliation: d 1st Department of Medicine , Charles University General Hospital , Prague , Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Trneny
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D018153:Czech Republic / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000379:methods; D000069283:Rituximab / Q000627:therapeutic use*; D059039:Standard of Care; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000069283:Rituximab
keywords: Follicular lymphoma; radiotherapy; rituximab