title: A single-institution retrospective analysis of outcomes for stage I-II primary mediastinal large B-cell lymphoma treated with immunochemotherapy with or without radiotherapy.
abstract: As the optimal treatment for primary mediastinal large B-cell lymphoma (PMBCL) remains undefined, we evaluated outcomes of patients treated with standard and dose-intense rituximab-chemotherapy (R-CT) with and without radiotherapy (RT). We retrospectively identified 28 patients with stage I-II PMBCL in our lymphoma database, re-reviewed pathology slides and scored interim or post-chemotherapy PET/CTs using the Deauville scale. Fourteen patients received RT (36-45 Gy) preceded by either six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or 12 weeks of rituximab, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and bleomycin (R-VACOP-B) with median follow-up of 94 months. Fourteen patients received 4-8 cycles of dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide and rituximab (DA-EPOCH-R) with median follow-up of 38 months; one of these received RT (36 Gy) due to post-chemotherapy PET/CT Deauville score 4. Following R-CT and RT or DA-EPOCH-R, 5-year and 3-year FFP and OS were both 100%. Both R-CHOP/R-VACOP-B with RT and DA-EPOCH-R demonstrate excellent outcomes.
authors.affiliation: a Department of Radiation Oncology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Binkley
authors.affiliation: a Department of Radiation Oncology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Hiniker
authors.affiliation: b Department of Pathology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Wu
authors.affiliation: b Department of Pathology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Yasodha
authors.initials: Y
authors.lastname: Natkunam
authors.affiliation: c Department of Radiology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Erik S
authors.initials: ES
authors.lastname: Mittra
authors.affiliation: d Department of Medicine , Division of Medical Oncology, Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Ranjana H
authors.initials: RH
authors.lastname: Advani
authors.affiliation: a Department of Radiation Oncology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Hoppe
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005047:Etoposide / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008479:Mediastinal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008875:Middle Aged; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D000069283:Rituximab; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D019788:Fluorodeoxyglucose F18; D001761:Bleomycin; D000069283:Rituximab; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Primary mediastinal large B-cell lymphoma