Addition of rituximab is not associated with survival benefit compared with CHOP alone for patients with stage Ⅰ diffuse large B-cell lymphoma

摘要

Background:The role of rituximab in combination with CHOP regimen in patients with stage I diffuse large B-cell lymphoma(DLBCL) remains to be defined.We aimed to compare CHOP plus rituximab(R-CHOP) with CHOP alone and determine the value of radiotherapy in these patients.Methods:Between 2003 and 2009,140 untreated patients with stage I DLBCL were retrospectively analyzed in this study.Results:Seventy-eight patients were treated in R-CHOP group and 62 in CHOP group.Ninety-one patients received additional radiotherapy at the end of chemotherapy.The different treatment groups were well-balanced with respect to baseline characteristics.Complete response(CR) rate was 77% both in R-CHOP and CHOP groups(P=0.945).After a median follow-up period of 56 months,patients received R-CHOP regimen had similar 5-year progression-free survival(PFS)(76%vs.85%;log-rank P=0.215)and 5-year overall survival(OS)(90%vs.96%;log-rank P=0.175) compared with those with CHOP alone.Patients with radiotherapy had significantly increased 5-year PFS compared with those who had chemotherapy alone(86%vs.71%;log-rank P=0.005).At multivariate analysis,patients who had CR(P=0.008) and received radiotherapy(P=0.003) were significantly associated with superior PFS.Conclusions:CHOP alone could be as effective as R-CHOP regimen and additional radiotherapy would be necessary for stage I or stage I non-bulky DLBCL patients.