Affiliation:
1. Fujian Medical University Union Hospital, Fujian Medical University
2. Fujian Medical University Union Hospital, Fujian Institute of Hematology
3. Fujian Medical University Union Hospital
4. The Third Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, The Third People’s Hospital of Fujian Province
Abstract
Abstract
Background: Radiotherapy (RT) is an effective and available local treatment for patients with refractory or relapsed (R/R) aggressive B-cell lymphomas. However, the value of hypofractionated RT in this setting has not been confirmed.
Methods: We retrospectively analyzed patients with R/R aggressive B-cell lymphoma who received hypofractionated RT between January 2020 and August 2022 at a single institution. The objective response rate (ORR), overall survival (OS), progression-free survival (PFS) and acute side effects were analyzed.
Results: A total of 30 patients were included. The median dose for residual disease was 36 Gy, at a dose per fraction of 2.3–5 Gy. After RT, the ORR and complete response (CR) rates were 90% and 80%, respectively. With a median follow-up of 10 months (range, 2–27 months), 10 patients (33.3%) experienced disease progression and three died. The 1-year OS and PFS rates for all patients were 81.8% and 66.3%, respectively. The majority (8/10) of post-RT progressions involved out-field relapses. Patients with relapsed diseases, no response to systemic therapy, multiple lesions at the time of RT, and no response to RT were associated with out-field relapses. PFS was associated with response to RT (P=0.001) and numbers of residual sites (P<0.001). No serious non-hematological adverse effects (≥grade 3) associated with RT were reported.
Conclusion: These data suggest that hypofractionated RT was effective and tolerable for patients with R/R aggressive B-cell lymphoma, especially for those that exhibited localized residual disease.
Publisher
Research Square Platform LLC
Reference62 articles.
1. Diffuse Large B-Cell Lymphoma;Sehn LH;N Engl J Med,2021
2. 2016 US lymphoid malignancy statistics by World Health Organization subtypes;Teras LR;CA Cancer J Clin,2016
3. Limited-stage diffuse large B-cell lymphoma;Hawkes EA;Blood,2022
4. A perspective on improving the R-CHOP regimen: from Mega-CHOP to ROBUST R-CHOP, the PHOENIX is yet to rise;Lue JK;Lancet Haematol,2020
5. Susanibar-Adaniya S, Barta SK. 2021 Update on Diffuse large B cell lymphoma: A review of current data and potential applications on risk stratification and management. Am J Hematol. 2021;96(5):617–629.