Evidence map›Paper›PMID 28748453›Full record

ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2017

Patterns of failure of diffuse large B‑cell lymphoma patients after involved-site radiotherapy.

Eva Holzhäuser, Maximilian Berlin, Daniel Wollschläger, Thomas Bezold, Arnulf Mayer, Georg Heß, Heinz Schmidberger

Abstract read
PubMed Publisher
In one paragraph

Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Eva HolzhäuserDepartment of Radiation Oncology and Radiotherapy, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany. eva.holzhaeuser@unimedizin-mainz.de.
Maximilian BerlinDepartment of Radiation Oncology and Radiotherapy, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Daniel WollschlägerInstitute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany.
Thomas BezoldDepartment of Radiation Oncology and Radiotherapy, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Arnulf MayerDepartment of Radiation Oncology and Radiotherapy, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Georg HeßDepartment of Internal Medicine, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Heinz SchmidbergerDepartment of Radiation Oncology and Radiotherapy, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRadiotherapy (RT) in combination with chemoimmunotherapy is highly efficient in the treatment of diffuse large B‑cell lymphoma (DLBCL). This retrospective analysis evaluated the efficacy of the treatment volume and the dose concept of involved-site RT (ISRT). PATIENTS AND

methodsWe identified 60 histologically confirmed stage I-IV DLBCL patients treated with multimodal cytotoxic chemoimmunotherapy and followed by consolidative ISRT from 2005-2015. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier method. Univariate analyses were performed by log-rank test and Mann-Whitney U‑test.

resultsAfter initial chemoimmunotherapy (mostly R‑CHOP; rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), 19 (36%) patients achieved complete response (CR), 34 (64%) partial response (PR) or less. Excluded were 7 (12%) patients with progressive disease after chemoimmunotherapy. All patients underwent ISRT with a dose of 40 Gy. After a median follow-up of 44 months, 79% of the patients remained disease free, while 21% presented with failure, progressive systemic disease, or death. All patients who achieved CR after chemoimmunotherapy remained in CR. Of the patients achieving PR after chemotherapy only 2 failed at the initial site within the ISRT volume. No marginal relapse was observed. Ann Arbor clinical stage I/II showed significantly improved PFS compared to stage III/IV (93% vs 65%; p ≤ 0.021). International Prognostic Index (IPI) score of 0 or 1 compared to 2-5 has been associated with significantly increased PFS (100% vs 70%; p ≤ 0.031). Postchemoimmunotherapy status of CR compared to PR was associated with significantly increased PFS (100% vs 68%; p ≤ 0.004) and OS (100% vs 82%; p ≤ 0.026). Only 3 of 53 patients developed grade II late side effects, whereas grade III or IV side effects have not been observed.

conclusionThese data suggest that a reduction of the RT treatment volume from involved-field (IF) to involved-site (IS) is sufficient because no marginal failures occurred. The concept of IS will likely reduce the risk for late sequelae of RT.

Indexed as

Treatment FailureAdultAgedAged, 80 and overAge DistributionDisease-Free SurvivalFemaleGermanyHumansLymphoma, Large B-Cell, DiffuseMaleMiddle AgedNeoplasm Recurrence, LocalPrevalenceRadiotherapy, ConformalRisk FactorsDiffuse large B‑cell lymphomaInvolved-nodeInvolved-siteLymphoma, non-HodgkinRadiotherapy

Identifiers

PMID28748453

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.