title: The role of radiotherapy for patients over age 60 with diffuse large B-cell lymphoma in the rituximab era.
abstract: The role of consolidative radiotherapy (RT) in patients ≥60 years old with DLBCL in the rituximab era is controversial. We examined the impact on disease control and overall survival by the addition of consolidative RT after completion of chemotherapy, while adjusting for known adverse risk factors. Retrospective chart review from 2004 to 2012 of 83 consecutive patients ≥60 years old with DLBCL treated in the rituximab era, 68 of which had a complete response to chemotherapy, was performed. Amongst patients with a complete response, consolidative RT use was associated with 100% 5-year local control, improved progression-free survival (p = 0.047), and a trend for overall survival (p = .098) on multivariate analysis. Amongst all patients, the use of consolidative RT was associated with improved overall survival (p = 0.03). The use of consolidative RT should be considered for patients ≥60 years old independent of stage and response to chemotherapy.
authors.affiliation: a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA ;
authors.forename: R J
authors.initials: RJ
authors.lastname: Cassidy
authors.affiliation: a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA ;
authors.forename: N
authors.initials: N
authors.lastname: Jegadeesh
authors.affiliation: b Biostatistics Shared Core Resource, Winship Cancer Institute , Atlanta , GA , USA ;
authors.forename: J
authors.initials: J
authors.lastname: Switchenko
authors.affiliation: a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA ;
authors.forename: H
authors.initials: H
authors.lastname: Danish
authors.affiliation: a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA ;
authors.forename: N
authors.initials: N
authors.lastname: Esiashvili
authors.affiliation: c Department of Hematology and Medical Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Flowers
authors.affiliation: a Department of Radiation Oncology , Winship Cancer Institute of Emory University , Atlanta , GA , USA ;
authors.forename: M K
authors.initials: MK
authors.lastname: Khan
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab / Q000627:therapeutic use*; D016896:Treatment Outcome; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Elderly; diffuse large B-cell lymphoma (DLBCL); radiotherapy