The outcome of combined-modality treatments for stage I and II primary large B-cell lymphoma of the mediastinum

摘要: Abstract Purpose: Primary mediastinal large B-cell lymphoma (PML) has clinicopathologic features distinct from those of other diffuse large-cell lymphomas. However, the optimal treatment for this tumor is evolving, and in particular, role radiation therapy remains undefined. We conducted a retrospective review to evaluate disease. Methods Materials: The medical records 40 consecutive patients with Ann Arbor Stage I or II PML treated at our institution January 1980 December 1995 were reviewed. There 18 disease 22 disease; 62.5% women 37.5% men. median age was 32.4 years (range, 17–74 years). scores 0 1 patient, 5 patients, 13 III 7 IV 4 unknown 10 patients. International Prognostic Index (IPI) 26 2 All doxorubicin-based chemotherapy, 35 received therapy. For most who therapy, an involved field modified-mantle used, dose Gy 20 fractions 39.6 administered. Univariate analysis performed identify prognostic factors. Results: follow-up surviving 56 months 19–194 months). actuarial 5-year relapse-free survival (RFS) rate overall (OS) all 67% 72%, respectively. Thirty-five achieved complete response; 32 these patterns failure responders as follows: locoregional alone patient (at margin field); distant patients; both (in-field) patient. no failures after 2.5 years. None never response had local control, died Only completed planned course therapy; massive treatment-related death initial chemotherapy One developed second malignancy (sarcoma) within score significant predictor RFS ( p = 0.016) OS 0.006), but IPI did not prove be predictor. Conclusion: recommend consolidative view excellent control lack toxicity. Modified mantle appears adequate volume, 39.6–40 dose. factor.