What question did this study set out to answer?

To evaluate clinical outcomes in patients with stage I–II primary mediastinal large B-cell lymphoma treated with standard or dose-intense immunochemotherapy, with or without consolidation radiotherapy.

July 10, 2015Leukemia & lymphoma/Leukemia and lymphoma

A single-institution retrospective analysis of outcomes for stage I–II primary mediastinal large B-cell lymphoma treated with immunochemotherapy with or without radiotherapy

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Why the study?

Does DA-EPOCH-R compared to R-CHOP/R-VACOP-B with radiotherapy improve outcomes in stage I-II primary mediastinal large B-cell lymphoma?

Population

28 patients with stage I-II primary mediastinal large B-cell lymphoma (PMBCL)

Comparison

Dose-adjusted etoposide, vincristine… vs Radiotherapy preceded by either 6 cycles of…

Design

Cohort

Follow-up

median 94 months for R-CT+RT, median 38 months for…

Authors

MBMichael S. BinkleyStanford University SHSusan M. HinikerStanford University SWSharon WuBoston College

Discussion

Member takes

Implication

Excellent outcomes with R-CT plus RT or DA-EPOCH-R alone; leaves open optimal regimen and RT omission in stage I-II PMBCL.

Key Points

To evaluate clinical outcomes in patients with stage I–II primary mediastinal large B-cell lymphoma treated with standard or dose-intense immunochemotherapy, with or without consolidation radiotherapy.
Retrospective single-institution analysis of 28 patients with stage I–II primary mediastinal large B-cell lymphoma with re-reviewed pathology slides and interim or post-chemotherapy PET/CT scored by Deauville criteria.
14 patients received radiotherapy (36–45 Gy) after 6 cycles of R-CHOP or 12 weeks of R-VACOP-B (median follow-up: 94 months).
14 patients received 4–8 cycles of DA-EPOCH-R (median follow-up: 38 months), with only 1 patient receiving radiotherapy (36 Gy) for a Deauville score of 4.
Patients treated with R-CHOP or R-VACOP-B plus radiotherapy achieved a 5-year freedom from progression and overall survival of 100%.
Patients treated with DA-EPOCH-R achieved a 3-year freedom from progression and overall survival of 100%.

Structured PICO

Does DA-EPOCH-R compared to R-CHOP/R-VACOP-B with radiotherapy improve outcomes in stage I-II primary mediastinal large B-cell lymphoma?

Population

28 patients with stage I-II primary mediastinal large B-cell lymphoma (PMBCL)

Intervention

Dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide and rituximab (DA-EPOCH-R) for 4-8 cycles (n=14)

Comparator

Radiotherapy (36-45 Gy) preceded by either 6 cycles of R-CHOP or 12 weeks of R-VACOP-B (n=14)

Outcome

5-year and 3-year freedom from progression (FFP) and overall survival (OS)hard clinical

Both R-CHOP/R-VACOP-B with radiotherapy and DA-EPOCH-R demonstrate excellent outcomes (100% FFP and OS) in stage I-II primary mediastinal large B-cell lymphoma.

Cite This Study

Binkley et al. (2015) studied this question.

synapsesocial.com/papers/6a7201972163a0a01bc5e45a https://doi.org/10.3109/10428194.2015.1067700

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A single-institution retrospective analysis of outcomes for stage I–II primary mediastinal large B-cell lymphoma treated with immunochemotherapy with or without radiotherapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

A single-institution retrospective analysis of outcomes for stage I–II primary mediastinal large B-cell lymphoma treated with immunochemotherapy with or without radiotherapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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