R-CHOP therapy alone in limited stage diffuse large B-cell lymphoma

Area of Science:

• Hematology
• Oncology
• Clinical Medicine

Background:

• Limited stage diffuse large B-cell lymphoma (DLBCL) conventionally treated with R-CHOP chemotherapy plus involved-field irradiation shows continuing relapse patterns.
• The standard treatment protocol involves three cycles of R-CHOP followed by radiotherapy.

Purpose of the Study:

• To evaluate the efficacy of six cycles of R-CHOP chemotherapy alone as a primary treatment for limited stage DLBCL.
• To compare outcomes of R-CHOP alone versus R-CHOP plus radiotherapy.

Main Methods:

• Retrospective analysis of 190 untreated patients with limited stage DLBCL receiving six cycles of full-dose R-CHOP.
• Exclusion of patients with more than 20% dose reduction.
• Allowed additional local irradiation for partial responders (PR).

Main Results:

• High response rates: 180 complete responses (CR), 8 partial responses (PR), 2 progression of disease (PD).
• 5-year progression-free survival (PFS) of 84% and 5-year overall survival (OS) of 90%.
• 29 patients experienced PD during follow-up; progression sites varied.

Conclusions:

• Six cycles of R-CHOP chemotherapy alone demonstrates comparable or superior efficacy to the standard R-CHOP plus radiotherapy regimen for limited stage DLBCL.
• R-CHOP alone may be a viable alternative to radiotherapy, potentially reducing treatment toxicity and complexity.