[1]Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Introduction: Consolidation radiotherapy after chemotherapy is commonly used in limited stage diffuse large B-cell lymphoma (DLBCL) of Waldeyer's ring. However, its role remains controversial, especially for patients achieving complete response (CR) after immunochemotherapy. Methods: We retrospectively and unselectively analyzed 72 patients with stage I/II DLBCL of Waldeyer's ring in our center. Eligible patients needed to receive at least 3 cycles of R-CHOP regimen and achieved CR either assessed by CT, MRI, or PET scan. (Table Presented) Results: Among 72 patients, 30 patients were treated with chemotherapy followed by radiotherapy (CT + RT group), and the median dose of RT was 36 Gy; 42 patients were treated with chemotherapy alone (CT group). Both groups were balanced for major characteristics as shown in Table 1, and the median cycles of chemotherapy were 6 in both groups. With a median follow-up time of 53 months, 5 patients had recurrent disease, and 3 died. Among 5 relapsed patients, only 1 had oropharyngeal primary, and other 4 had nasopharyngeal primary. Regarding initial treatment, 2 patients received combined treatment, and 3 received chemotherapy alone. The 5-year progression-free survival (PFS) rates were 93.3% in CT + RT group and 92.5% in CT group with a P value of .896. The 5-year overall survival (OS) rates were 96.7% and 94.4%, respectively (P = .649). Since 4 of 15 patients with nasopharyngeal primary relapsed, we did a subgroup analysis, which showed both 5-year PFS and OS rates in oropharynx group was higher as compared with those in nasopharynx group (PFS: 98.2% vs 73.3%, P = .001; OS: 100% vs 79.0%, P = .001). Moreover, primary site was confirmed to be the only independent prognostic factor for PFS in multivariate analysis (P = .012, HR 16.858 [95% CI, 1.883-150.933]). Conclusions: In patients with limited stage DLBCL of Waldeyer's ring achieving CR after immunochemotherapy, consolidation radiotherapy does not improve the treatment outcome. Nasopharyngeal primary could be an unfavorable factor, which should be confirmed in large population or prospective studies.
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