TY - JOUR
T1 - The long term follow-up of early stage follicular lymphoma treated with radiotherapy, chemotherapy or combined modality treatment
AU - Sancho, Juan Manuel
AU - García, Olga
AU - Mercadal, Santiago
AU - Pomares, Helena
AU - Fernández-Alvarez, Rubén
AU - González-Barca, Eva
AU - Tapia, Gustavo
AU - González-García, Esther
AU - Moreno, Miriam
AU - Domingo-Domènech, Eva
AU - Sorigué, Marc
AU - Navarro, José Tomás
AU - Motlló, Cristina
AU - Fernández-de-Sevilla, Alberto
AU - Feliu, Evarist
AU - Ribera, Josep Maria
PY - 2015/8/1
Y1 - 2015/8/1
N2 - © 2015 Elsevier Ltd. Local (involved-field or recently involved-site) radiotherapy is the standard therapy in limited-stage follicular lymphoma (FL). We retrospectively analyzed the value of chemotherapy in 130 patients with limited-stage FL (46 treated with radiotherapy alone [RT group], 30 with radiotherapy plus chemotherapy [COMBINED group] and 43 with chemotherapy alone [CHEMO group], 11 were managed with observation). Ninety-six percent of patients responded (RT 98%, COMBINED 100%, CHEMO 91%, p = 0.179), and 37% (40/107) of patients in complete response relapsed (RT 42%, COMBINED 27%, CHEMO 41%, p = 0.371). Progression-free survival (PFS) and overall survival (OS) probabilities at 10 years were similar in RT, COMBINED and CHEMO patients (PFS 41%, 61% and 39% [p = 0.167], and OS 77%, 81% and 72% [ p = 0.821], respectively), while the COMBINED group showed a trend to better time-to-progression (TTP 43%, 72% and 47% [ p = 0.055]). On multivariate analysis, only a FLIPI score ≥2 showed a trend to influence PFS (HR 2.1 [95% confidence interval 0.9-4.6], p = 0.067), and OS (HR 2.4 [0.9-6.5], p = 0.084), while patients treated with radiotherapy plus chemotherapy (COMBINED group) showed a significantly better TTP compared with those receiving only RT (HR 0.3 [0.1-0.8], p = 0.024). In our study no benefit was observed in survival with the use of systemic therapy compared with local radiotherapy.
AB - © 2015 Elsevier Ltd. Local (involved-field or recently involved-site) radiotherapy is the standard therapy in limited-stage follicular lymphoma (FL). We retrospectively analyzed the value of chemotherapy in 130 patients with limited-stage FL (46 treated with radiotherapy alone [RT group], 30 with radiotherapy plus chemotherapy [COMBINED group] and 43 with chemotherapy alone [CHEMO group], 11 were managed with observation). Ninety-six percent of patients responded (RT 98%, COMBINED 100%, CHEMO 91%, p = 0.179), and 37% (40/107) of patients in complete response relapsed (RT 42%, COMBINED 27%, CHEMO 41%, p = 0.371). Progression-free survival (PFS) and overall survival (OS) probabilities at 10 years were similar in RT, COMBINED and CHEMO patients (PFS 41%, 61% and 39% [p = 0.167], and OS 77%, 81% and 72% [ p = 0.821], respectively), while the COMBINED group showed a trend to better time-to-progression (TTP 43%, 72% and 47% [ p = 0.055]). On multivariate analysis, only a FLIPI score ≥2 showed a trend to influence PFS (HR 2.1 [95% confidence interval 0.9-4.6], p = 0.067), and OS (HR 2.4 [0.9-6.5], p = 0.084), while patients treated with radiotherapy plus chemotherapy (COMBINED group) showed a significantly better TTP compared with those receiving only RT (HR 0.3 [0.1-0.8], p = 0.024). In our study no benefit was observed in survival with the use of systemic therapy compared with local radiotherapy.
KW - Chemotherapy
KW - Follicular lymphoma
KW - Limited stage
KW - Radiotherapy
U2 - 10.1016/j.leukres.2015.05.009
DO - 10.1016/j.leukres.2015.05.009
M3 - Article
VL - 39
SP - 853
EP - 858
JO - Leukemia Research
JF - Leukemia Research
SN - 0145-2126
IS - 8
ER -