Rituximab-era retrospective studies
| Therapeutic strategy . | Study design . | n . | Patient characteristics . | Treatment details . | Median follow-up (y) . | PFS . | OS (95% CI) . |
|---|---|---|---|---|---|---|---|
| Combined modality vs standard R-CHOP | Multicenter Osaka Lymphoma Study Group48 | 137 | All LS-DLBCL Nonbulky only (<10 cm) Details not specified | R-CHOP 3-4 + RT vs R-CHOP 6-8 | 2.83 | 3-y PFS* 74% R-CHOP vs 89.7% R-CHOP + IFRT | 3-y OS* 85.5% R-CHOP vs 96.2% R-CHOP+IFRT |
| Combined modality vs standard R-CHOP | Single-center Memorial-Sloan Kettering24 | 261 | All LS-DLBCL Nonbulky only (<10 cm) Age: all (>60 = 48%) stage II: 32% Extranodal: 51% Bulk: 0% (excluded) | R-CHOP ×3-4 R-CHOP 3-4 + RT R-CHOP ×6 R-CHOP ×6 + RT | 4.7 | 5-y PFS 92% 94% R-CHOP ×3-4 89% R-CHOP x3 + IFRT 79.9% R-CHOP x6 89.8% R-CHOP x6 + IFRT | 5-y OS 93% 100% R-CHOP ×3-4 93.5% R-CHOP + RT 84.5% R-CHOPx6 97.8% R-CHOPx6 + RT |
| Combined modality vs standard R-CHOP | Multicenter SEER Database49 | 874 | Elderly LS-DLBCL Bulk status not reported Age: ≥66 y Stage II: 40% B Symptoms: 11% Extranodal: 33% | R-CHOP ×3-4 + RT vs R-CHOP ×6-8 | 4.2 | 5-y EFS 24% R-CHOP ×3-4 + IFRT vs 33% R-CHOP ×6-8 HR 0.71 P = .02 | 5-y OS* 77% R-CHOP ×3-4 + RT vs 76% R-CHOP ×6-8 |
| Standard chemo +/− IFRT | Single-center MD Anderson7 | 469 (190 LS- DLBCL) | Stage I-IV included Bulk permitted: defined as >5 cm Age: all (medial 61 y) Stage I/II: 20%/20% Other parameters not specifically reported for LS-DLBCL | R-CHOP-like 6-8 +/− RT 30% “other” chemo | 3 | LS-DLBCL cohort results: 5-y PFS 81% overall 82% RT vs 68% no RT (P = .003) | LS-DLBCL cohort results: 5-y OS 83% overall 92% RT vs 73% no RT (P = .007) |
| Standard R-CHOP +/− RT | Multicenter NCCN Institutions51 | 841 (402 LS-DLBCL) | Stages I-IV included Bulk permitted: Defined as ≥10 cm Age: all (median 57 y) Stage I/II: 26%/22% B Symptoms: 28.5% Extranodal: 26% Bulk: 23% | R-CHOP ×6-8 +/− IFRT | 4.5 | LS-DLBCL cohort results: HR 1.81, P = .15 for RT | LS-DLBCL cohort results: OS HR 0.94, P = .89 for RT |
| Standard R-CHOP +/− RT | Single-center Seoul National University Hospital50 | 198 | All LS-DLBCL Bulk permitted: defined as ≥7 cm Age: Median 55 Stage II: 67% PS > 1: 7.6% Elevated LDH: 41% B Symptoms: 14% Extranodal: 63% Bulk: 30% | R-CHOP ×6-8 +/− IFRT | 3.3 | 3-y PFS 85.8% 83.9% no RT vs 92.7% RT P = .021 | 3-y OS 88.9% 95% no RT vs 87.1% RT P = .014 |
| Combined modality vs abbreviated or standard R-CHOP alone | Single-center Memorial Sloan-Kettering20 | 341 | Stage I only Nonbulky only (≤7.5 cm) Age: Median 60 y Stage II: 0% PS > 1: 3% Elevated LDH 22% B Symptoms: 3% Extranodal: 66% Bulk: 0% (excluded) | R-CHOP ×3-4 +/− RT R-CHOP ×6 +/− RT | 5.5 | 10-y PFS 77% 63% Extranodal vs 85% Nodal HR 0.35 for extranodal disease in favor of RT P < .001 | 5-y OS 94% 10-y OS 77% 70% extranodal vs 89% Nodal HR 0.26 for extranodal disease in favor of RT P < 0.001 |
| PET-adapted | Single-center BC Cancer21 | 319 | All LS-DLBCL Nonbulky only (<10 cm) No B Symptoms Age: median 68 y Stage II: 8% PS > 1: 13% B symptoms: 0% Elevated LDH: 52% Extranodal: 37% Bulk: 0% (excluded) PE+: 18% | R-CHOP x3 then PET+: RT PET−: R-CHOP ×1 | 6.25 | 5-y PFS 84% 88% PET−* vs 74% PET+* | 5-y OS 87% 90% PET−* vs 77% PET+* |
| Therapeutic strategy . | Study design . | n . | Patient characteristics . | Treatment details . | Median follow-up (y) . | PFS . | OS (95% CI) . |
|---|---|---|---|---|---|---|---|
| Combined modality vs standard R-CHOP | Multicenter Osaka Lymphoma Study Group48 | 137 | All LS-DLBCL Nonbulky only (<10 cm) Details not specified | R-CHOP 3-4 + RT vs R-CHOP 6-8 | 2.83 | 3-y PFS* 74% R-CHOP vs 89.7% R-CHOP + IFRT | 3-y OS* 85.5% R-CHOP vs 96.2% R-CHOP+IFRT |
| Combined modality vs standard R-CHOP | Single-center Memorial-Sloan Kettering24 | 261 | All LS-DLBCL Nonbulky only (<10 cm) Age: all (>60 = 48%) stage II: 32% Extranodal: 51% Bulk: 0% (excluded) | R-CHOP ×3-4 R-CHOP 3-4 + RT R-CHOP ×6 R-CHOP ×6 + RT | 4.7 | 5-y PFS 92% 94% R-CHOP ×3-4 89% R-CHOP x3 + IFRT 79.9% R-CHOP x6 89.8% R-CHOP x6 + IFRT | 5-y OS 93% 100% R-CHOP ×3-4 93.5% R-CHOP + RT 84.5% R-CHOPx6 97.8% R-CHOPx6 + RT |
| Combined modality vs standard R-CHOP | Multicenter SEER Database49 | 874 | Elderly LS-DLBCL Bulk status not reported Age: ≥66 y Stage II: 40% B Symptoms: 11% Extranodal: 33% | R-CHOP ×3-4 + RT vs R-CHOP ×6-8 | 4.2 | 5-y EFS 24% R-CHOP ×3-4 + IFRT vs 33% R-CHOP ×6-8 HR 0.71 P = .02 | 5-y OS* 77% R-CHOP ×3-4 + RT vs 76% R-CHOP ×6-8 |
| Standard chemo +/− IFRT | Single-center MD Anderson7 | 469 (190 LS- DLBCL) | Stage I-IV included Bulk permitted: defined as >5 cm Age: all (medial 61 y) Stage I/II: 20%/20% Other parameters not specifically reported for LS-DLBCL | R-CHOP-like 6-8 +/− RT 30% “other” chemo | 3 | LS-DLBCL cohort results: 5-y PFS 81% overall 82% RT vs 68% no RT (P = .003) | LS-DLBCL cohort results: 5-y OS 83% overall 92% RT vs 73% no RT (P = .007) |
| Standard R-CHOP +/− RT | Multicenter NCCN Institutions51 | 841 (402 LS-DLBCL) | Stages I-IV included Bulk permitted: Defined as ≥10 cm Age: all (median 57 y) Stage I/II: 26%/22% B Symptoms: 28.5% Extranodal: 26% Bulk: 23% | R-CHOP ×6-8 +/− IFRT | 4.5 | LS-DLBCL cohort results: HR 1.81, P = .15 for RT | LS-DLBCL cohort results: OS HR 0.94, P = .89 for RT |
| Standard R-CHOP +/− RT | Single-center Seoul National University Hospital50 | 198 | All LS-DLBCL Bulk permitted: defined as ≥7 cm Age: Median 55 Stage II: 67% PS > 1: 7.6% Elevated LDH: 41% B Symptoms: 14% Extranodal: 63% Bulk: 30% | R-CHOP ×6-8 +/− IFRT | 3.3 | 3-y PFS 85.8% 83.9% no RT vs 92.7% RT P = .021 | 3-y OS 88.9% 95% no RT vs 87.1% RT P = .014 |
| Combined modality vs abbreviated or standard R-CHOP alone | Single-center Memorial Sloan-Kettering20 | 341 | Stage I only Nonbulky only (≤7.5 cm) Age: Median 60 y Stage II: 0% PS > 1: 3% Elevated LDH 22% B Symptoms: 3% Extranodal: 66% Bulk: 0% (excluded) | R-CHOP ×3-4 +/− RT R-CHOP ×6 +/− RT | 5.5 | 10-y PFS 77% 63% Extranodal vs 85% Nodal HR 0.35 for extranodal disease in favor of RT P < .001 | 5-y OS 94% 10-y OS 77% 70% extranodal vs 89% Nodal HR 0.26 for extranodal disease in favor of RT P < 0.001 |
| PET-adapted | Single-center BC Cancer21 | 319 | All LS-DLBCL Nonbulky only (<10 cm) No B Symptoms Age: median 68 y Stage II: 8% PS > 1: 13% B symptoms: 0% Elevated LDH: 52% Extranodal: 37% Bulk: 0% (excluded) PE+: 18% | R-CHOP x3 then PET+: RT PET−: R-CHOP ×1 | 6.25 | 5-y PFS 84% 88% PET−* vs 74% PET+* | 5-y OS 87% 90% PET−* vs 77% PET+* |
IFRT, involved field radiotherapy.
Not statistically significant.