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R-CHOP with dose-attenuated radiation therapy could induce good prognosis in gastric diffuse large B cell lymphoma

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Author(s): Mishima Yuko | Terui Yasuhito | Yokoyama Masahiro | Nishimura Noriko | Sakajiri Sakura | Ueda Kyoko | Kuboki Yasutoshi | Nakano Kenji | Suzuki Kazuhito | Nara Eriko | Tsuyama Naoko | Takeuchi Kengo | Oguchi Masahiko | Hatake Kiyohiko

Journal: Experimental Hematology & Oncology
ISSN 2162-3619

Volume: 1;
Issue: 1;
Start page: 30;
Date: 2012;
Original page

Keywords: Gastric DLBCL | Radiation | R-CHOP

ABSTRACT
Abstract Background The treatment strategy for gastric diffuse large cell lymphoma (DLBCL) has not been standardized in such as to the cycles of chemotherapy, dose of radiation, or necessity for the surgery. Although the results of CHOP or R-CHOP treatments have demonstrated the good prognosis, the treatments have been controversial in many cases. Methods We retrospectively analyzed 40 gastric DLBCL patients receiving chemotherapy with or without radiation in our institute. Those in stages II-IV were treated with six cycles of R-CHOP without radiation; for those in stage I, we administered three cycles of R-CHOP with radiation. Results The three-year overall survival (OS) and progression-free survival (PFS) rates were 95.2 and 91.8%, respectively. Those in stage I obtained 100% of OS. The radiation dose prescribed was 30.6 Gy for CR cases and 39.6 to 40 Gy for PR after chemotherapy. Although survival rates tended to correlate with staging groups or age-adjusted IPI classifications, multivariate statistical analysis did not show clear differences. All 14 patients with initial bleeding were successfully managed without surgery during treatment. Conclusion R-CHOP therapy was very effective for gastric DLBCL. It may be not necessary to use more than 30.6 Gy of radiotherapy in the highly chemo-sensitive cases. Less toxic treatments should be made available to gastric DLBCL patients.

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