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Significance of bulky mass and residual tumor—Treated with or without consolidative radiotherapy—To the risk of relapse in DLBCL patients
Bulky and residual tumor are considered to increase the risk of relapse in diffuse large B‐cell lymphoma (DLBCL) patients. Radiotherapy is conventionally used to reduce the risk, but the evidence is controversial. We performed a retrospective analysis to evaluate the significance of bulky and residu...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064117/ https://www.ncbi.nlm.nih.gov/pubmed/31967739 http://dx.doi.org/10.1002/cam4.2798 |
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author | Tokola, Susanna Kuitunen, Hanne Turpeenniemi‐Hujanen, Taina Kuittinen, Outi |
author_facet | Tokola, Susanna Kuitunen, Hanne Turpeenniemi‐Hujanen, Taina Kuittinen, Outi |
author_sort | Tokola, Susanna |
collection | PubMed |
description | Bulky and residual tumor are considered to increase the risk of relapse in diffuse large B‐cell lymphoma (DLBCL) patients. Radiotherapy is conventionally used to reduce the risk, but the evidence is controversial. We performed a retrospective analysis to evaluate the significance of bulky and residual tumor treated with or without radiotherapy in DLBCL patients. We analyzed 312 DLBCL patients treated from 2010‐2017 in Oulu University Hospital. A bulky tumor was detected in 123 patients and 55 of these patients (44.3%) received consolidative radiation therapy (RT) to the bulky tumor. Residual tumor meeting the required criteria was found in 138 (39.3%) patients, and 65 (45.5%) of these patients received consolidative RT to the site of residual tumor. iPET‐CT scans were performed in 102 patients. In multivariate analyses, bulky was an independent risk factor in limited stage patients in progression free survival (HR 6.43 [95%CI 1.609‐25.710]; P = .008) not related to International prognostic index (HR 1.35 [95% CI 0.256‐7.124]; P = .724) or age (HR 1.62 [95% CI 0.468‐5.638]; P = .445). This was not seen in advanced stage patients or in patients with residual tumor. Radiotherapy to the bulky or residual tumor was not able to improve the long‐term PFS of patients. In this study, it appears that performing iPET is the most convincing method in improving evaluation and in finding patients with increased risk of relapse. Evidently, patients with negative iPET will not benefit from including RT in the treatment after metabolic complete response (CR), and patients with primary refractory disease are most likely in the group of positive iPET. |
format | Online Article Text |
id | pubmed-7064117 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-70641172020-03-16 Significance of bulky mass and residual tumor—Treated with or without consolidative radiotherapy—To the risk of relapse in DLBCL patients Tokola, Susanna Kuitunen, Hanne Turpeenniemi‐Hujanen, Taina Kuittinen, Outi Cancer Med Clinical Cancer Research Bulky and residual tumor are considered to increase the risk of relapse in diffuse large B‐cell lymphoma (DLBCL) patients. Radiotherapy is conventionally used to reduce the risk, but the evidence is controversial. We performed a retrospective analysis to evaluate the significance of bulky and residual tumor treated with or without radiotherapy in DLBCL patients. We analyzed 312 DLBCL patients treated from 2010‐2017 in Oulu University Hospital. A bulky tumor was detected in 123 patients and 55 of these patients (44.3%) received consolidative radiation therapy (RT) to the bulky tumor. Residual tumor meeting the required criteria was found in 138 (39.3%) patients, and 65 (45.5%) of these patients received consolidative RT to the site of residual tumor. iPET‐CT scans were performed in 102 patients. In multivariate analyses, bulky was an independent risk factor in limited stage patients in progression free survival (HR 6.43 [95%CI 1.609‐25.710]; P = .008) not related to International prognostic index (HR 1.35 [95% CI 0.256‐7.124]; P = .724) or age (HR 1.62 [95% CI 0.468‐5.638]; P = .445). This was not seen in advanced stage patients or in patients with residual tumor. Radiotherapy to the bulky or residual tumor was not able to improve the long‐term PFS of patients. In this study, it appears that performing iPET is the most convincing method in improving evaluation and in finding patients with increased risk of relapse. Evidently, patients with negative iPET will not benefit from including RT in the treatment after metabolic complete response (CR), and patients with primary refractory disease are most likely in the group of positive iPET. John Wiley and Sons Inc. 2020-01-22 /pmc/articles/PMC7064117/ /pubmed/31967739 http://dx.doi.org/10.1002/cam4.2798 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Tokola, Susanna Kuitunen, Hanne Turpeenniemi‐Hujanen, Taina Kuittinen, Outi Significance of bulky mass and residual tumor—Treated with or without consolidative radiotherapy—To the risk of relapse in DLBCL patients |
title | Significance of bulky mass and residual tumor—Treated with or without consolidative radiotherapy—To the risk of relapse in DLBCL patients |
title_full | Significance of bulky mass and residual tumor—Treated with or without consolidative radiotherapy—To the risk of relapse in DLBCL patients |
title_fullStr | Significance of bulky mass and residual tumor—Treated with or without consolidative radiotherapy—To the risk of relapse in DLBCL patients |
title_full_unstemmed | Significance of bulky mass and residual tumor—Treated with or without consolidative radiotherapy—To the risk of relapse in DLBCL patients |
title_short | Significance of bulky mass and residual tumor—Treated with or without consolidative radiotherapy—To the risk of relapse in DLBCL patients |
title_sort | significance of bulky mass and residual tumor—treated with or without consolidative radiotherapy—to the risk of relapse in dlbcl patients |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064117/ https://www.ncbi.nlm.nih.gov/pubmed/31967739 http://dx.doi.org/10.1002/cam4.2798 |
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