The treatment of primary mediastinal large B-cell lymphoma: a two decades monocentric experience with 98 patients

Bibliographic Details
Title: The treatment of primary mediastinal large B-cell lymphoma: a two decades monocentric experience with 98 patients
Authors: Alessandro Broccoli, Beatrice Casadei, Vittorio Stefoni, Cinzia Pellegrini, Federica Quirini, Lorenzo Tonialini, Alice Morigi, Miriam Marangon, Lisa Argnani, Pier Luigi Zinzani
Source: BMC Cancer, Vol 17, Iss 1, Pp 1-8 (2017)
Publisher Information: BMC, 2017.
Publication Year: 2017
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Chemotherapy, MACOP-B, primary mediastinal lymphoma, radiotherapy, rituximab, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract Background The purpose of this study is to investigate the most suitable first-line approach and the best combination treatment for primary mediastinal large B-cell lymphoma (PMLBCL) as they have been matter of debate for at least two decades. Methods Our single centre experience in the treatment of 98 de novo PMLBCL patients over the last 20 years is reviewed. All patients received MACOP-B chemotherapy. Thirty-seven received both rituximab and mediastinal radiotherapy; 30 were irradiated after chemotherapy, although not receiving rituximab and 20 received rituximab without radiotherapy consolidation. Eleven patients received chemotherapy only. Results Sixty-one (62.2%) patients achieved a complete response after MACOP-B (with or without rituximab); among the 27 (27.6%) partial responders, 21 obtained a complete response after radiotherapy. At the end of their scheduled treatment, 82 patients (83.7%) had a complete and 6 a partial response (6.1%). Eleven patients relapsed within the first 2 years of follow-up. The 17-year overall survival is 72.0% (15 patients died); progression-free and disease-free survival are 67.6% and 88.4%, respectively. A statistically significant difference in overall and progression-free survival was noted among treatment groups, although no disease-free survival difference was documented. Conclusions Our data indicate that a third-generation regimen like MACOP-B could be considered a suitable first-line treatment. Mediastinal consolidation radiotherapy impacts on survival and complete response rates and remains a good strategy to convert partial into complete responses. Data suggest that radiotherapy may be avoided in patients obtaining a complete response after (immuno)chemotherapy, but this requires confirmation with further ad hoc studies.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2407
Relation: http://link.springer.com/article/10.1186/s12885-017-3269-6; https://doaj.org/toc/1471-2407
DOI: 10.1186/s12885-017-3269-6
Access URL: https://doaj.org/article/57025dcd6c6441119dc1a81a2b6a4fa4
Accession Number: edsdoj.57025dcd6c6441119dc1a81a2b6a4fa4
Database: Directory of Open Access Journals
More Details
ISSN:14712407
DOI:10.1186/s12885-017-3269-6
Published in:BMC Cancer
Language:English