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Clinical Trial
. 2004 Jan 26;90(2):372-6.
doi: 10.1038/sj.bjc.6601460.

Primary mediastinal large B-cell lymphoma (PMLBCL): long-term results from a retrospective multicentre Italian experience in 138 patients treated with CHOP or MACOP-B/VACOP-B

G Todeschini  1 , S Secchi, E Morra, U Vitolo, E Orlandi, F Pasini, E Gallo, A Ambrosetti, C Tecchio, C Tarella, A Gabbas, A Gallamini, L Gargantini, M Pizzuti, G Fioritoni, L Gottin, G Rossi, M Lazzarino, F Menestrina, M Paulli, M Palestro, M G Cabras, F Di Vito, G Pizzolo
Affiliations
Clinical Trial

Primary mediastinal large B-cell lymphoma (PMLBCL): long-term results from a retrospective multicentre Italian experience in 138 patients treated with CHOP or MACOP-B/VACOP-B

G Todeschini et al. Br J Cancer. .

Abstract

The optimal treatment of primary mediastinal large B-cell lymphoma (PMLBCL) is still undefined. In the absence of randomised studies, we retrospectively analysed: (a) the effectiveness of two chemotherapy regimens (CHOP vs MACOP-B/VACOP-B) in complete remission (CR) achievement and event-free survival (EFS) and (b) the role of mediastinal involved-field radiotherapy (IF-RT) as consolidation. From 1982 to 1999, 138 consecutive patients affected by PMLBCL were treated in 13 Italian institutions with CHOP (43) or MACOP-B/VACOP-B (95). The two groups of patients were similar as regard to age, gender, presence of bulky mediastinal mass, pleural effusion, stage and international prognostic indexes category of risk. Overall, 75.5% of patients in CR received IF-RT as consolidation. Complete remission was 51.1% in the CHOP group and 80% in MACOP-B/VACOP-B (P<0.001). Relapse occurred in 22.7% of CHOP- and in 9.2% of MACOP-B/VACOP-B-treated patients (n.s.). Event-free patients were 39.5% in CHOP and 75.7% in the MACOP-B/VACOP-B group (P<0.001). The addition of IF-RT as consolidation improved the outcome, irrespectively of the type of chemotherapy (P=0.04). At a multivariate analysis, achievement of CR (P<0.0001) and type of CT (MACOP-B/VACOP-B) retained the significance for OS (P=0.008) and EFS (P=0.03). In our experience, MACOP-B/VACOP-B appears to positively influence OS and EFS in patients affected by PMLBCL, as compared to CHOP. Consolidation IF-RT on mediastinum further improves the outcome of CR patients.

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Figures

Figure 1
Figure 1
Event-free survival in CHOP- vs MACOP/VACOP-B-treated patients.
Figure 2
Figure 2
Event-free survival in CR patients treated or not with IF-RT.
See this image and copyright information in PMC

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