Older patients with early-stage diffuse large B-cell lymphoma: the role of consolidation radiotherapy after chemoimmunotherapy.
The purpose of this study was to examine the association between RT and overall survival for older patients (>60 years) with early-stage diffuse large B-cell lymphoma (DLBCL) using standard and propensity score (PS)-adjusted Cox proportional hazards models. From 1998 to 2012, 2207 patients were over the age of 60 years, received chemoimmunotherapy with or without RT and were included in this study. Use of consolidation RT was associated with lower clinical stage, head/neck involved site, lack of 'B' symptoms, lower co-morbidity score, and higher socioeconomic status (all p < .05). Examining 1721 patients for survival outcomes (1998-2008), the 5-year overall survival for patients receiving RT was 80.1% versus 69.8% for those not receiving RT (p < .01). After PS-matching for co-variates, RT use remained associated with improved overall survival (HR = 0.63, 95% CI, 0.51-0.79, p < .01). Over the study period, RT utilization decreased from 38.5% to 28.8%. Consolidation RT was associated with improved OS for older patients with early-stage DLBCL receiving chemoimmunotherapy.
a Department of Radiation Oncology , Rutgers Cancer Institute of New Jersey , New Brunswick , NJ , USA.
Rahul R
RR
Parikh
b Department of Radiation Oncology , Memorial Sloan-Kettering Cancer Center , New York , NY , USA.
Joachim
J
Yahalom
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D059248:Chemoradiotherapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D057216:Propensity Score; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
National Cancer Database; Non-Hodgkin lymphoma; consolidation radiotherapy; elderly; overall survival