Bitte benutzen Sie diese Referenz, um auf diese Ressource zu verweisen: doi:10.22028/D291-43486
Titel: Radiation and Dose-densification of R-CHOP in Primary Mediastinal B-cell Lymphoma: Subgroup Analysis of the UNFOLDER Trial
VerfasserIn: Held, Gerhard
Thurner, Lorenz
Poeschel, Viola
Ott, German
Schmidt, Christian
Christofyllakis, Konstantinos
Viardot, Andreas
Borchmann, Peter
Engel-Riedel, Walburga
Frickhofen, Norbert
Nickelsen, Maike
Shpilberg, Ofer
Witzens-Harig, Mathias
Griesinger, Frank
Krammer-Steiner, Beate
Neubauer, Andreas
de Nully Brown, Peter
Federico, Massimo
Glass, Bertram
Schmitz, Norbert
Wulf, Gerald
Truemper, Lorenz
Bewarder, Moritz
Murawski, Niels
Stilgenbauer, Stephan
Rosenwald, Andreas
Altmann, Bettina
Engelhard, Marianne
Schmidberger, Heinz
Fleckenstein, Jochen
Berdel, Christian
Loeffler, Markus
Ziepert, Marita
Sprache: Englisch
Titel: HemaSphere : open access journal of the European Hematology Association
Bandnummer: 7
Heft: 7
Verlag/Plattform: Wolters Kluwer Health
Erscheinungsjahr: 2023
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: UNFOLDER (NCT00278408, EUDRACT 2005-005218-19) is a phase-3 trial in patients with aggressive B-cell lymphoma and intermediate prognosis, including primary mediastinal B-cell lymphoma (PMBCL). In a 2 × 2 factorial design, patients were randomized to 6× R-CHOP-14 or R-CHOP-21 (rituximab, cyclophosphamide, doxorubicin, vincristine, and prediso(lo)ne) and to consolidation radiotherapy to extralymphatic/bulky disease or observation. Response was assessed according to the standardized criteria from 1999, which did not include F-18 fluordesoxyglucose positron emission tomography/computed tomography (FDG-PET) scans. Primary end point was event-free survival (EFS). A subgroup of 131 patients with PMBCLs was included (median age, 34 y; 54% female, 79% elevated lactate dehydrogenase (LDH), 20% LDH >2× upper limit of normal [ULN], and 24% extralymphatic involvement). Eighty-two (R-CHOP-21: 43 and R-CHOP-14: 39) patients were assigned to radiotherapy and 49 (R-CHOP-21: 27, R-CHOP-14: 22) to observation. The 3-year EFS was superior in radiotherapy arm (94% [95% confidence interval (CI), 89-99] versus 78% [95% CI, 66-89]; P = 0.0069), due to a lower rate of partial responses (PRs) (2% versus 10%). PR triggered additional treatment, mostly radiotherapy (n = 5; PR: 4; complete response/unconfirmed complete response: 1). No significant differences were observed in progression-free survival (PFS) (95% [95% CI, 90-100] versus 90% [95% CI, 81-98]; P = 0.25) nor in overall survival (OS) (98% [95% CI, 94-100] versus 96% [95% CI, 90-100]; P = 0.64). Comparing R-CHOP-14 and R-CHOP-21, EFS, PFS, and OS were not different. A prognostic marker for adverse outcome was elevated LDH >2× ULN (EFS: P = 0.016; PFS: P = 0.0049; OS: P = 0.0014). With the limitation of a pre-PET-era trial, the results suggest a benefit of radiotherapy only for patients responding to R-CHOP with PR. PMBCL treated with R-CHOP have a favorable prognosis with a 3-year OS of 97%.
DOI der Erstveröffentlichung: 10.1097/HS9.0000000000000917
URL der Erstveröffentlichung: https://journals.lww.com/hemasphere/fulltext/2023/07000/radiation_and_dose_densification_of_r_chop_in.11.aspx
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-434860
hdl:20.500.11880/38977
http://dx.doi.org/10.22028/D291-43486
ISSN: 2572-9241
Datum des Eintrags: 18-Nov-2024
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Prof. Dr. Stephan Stilgenbauer
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

Dateien zu diesem Datensatz:
Datei Beschreibung GrößeFormat 
radiation_and_dose_densification_of_r_chop_in.11.pdf850,9 kBAdobe PDFÖffnen/Anzeigen


Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons Creative Commons