Adding Radiotherapy Boosts Outcomes Among Elderly with B-cell Lymphomas

Adding radiotherapy to combination chemotherapy improved outcomes in older patients diagnosed with aggressive, bulky B-cell lymphoma

New research indicates this may be a valid treatment route for this patient population, for two reasons:

• 1. Many are not candidates for stem cell transplantation.
• 2. They are at a much lower risk of enduring or experiencing the known long-term and potentially carcinogenic effects of radiotherapy due to their age and to the amount of time it requires for those problems to develop.

In this study, researchers recruited 306 patients between 61 to 80 from the RICOVER-60 cohort. They received rituximab plus CHOP, or R-CHOP, in addition to 36 Gy involved-field radiation therapy to the bulky sites of the disease.

Meanwhile, another cohort of 164 patients received the same regimen minus the radiotherapy.

Analysis of the data amount to a finding that patients who did not receive radiotherapy had substantially lower rates of event-free survival, progression-free survival, and overall survival.

The researchers wrote,

Our analysis of two prospectively treated cohorts from the RICOVER-60 trial provides strong support for adding radiation therapy to sites of bulky disease for elderly patients with aggressive B-cell lymphoma. We recommend this additive and (at doses of 36 Gy) relatively low-toxic treatment modality in all patients with bulky disease until a prospective study proves that it can be omitted in patients with a negative PET after immunochemotherapy.

Their findings appear in the Journal of Clinical Oncology.

Source: JCO