A phase II trial of RCHOP followed by radioimmunotherapy for early stage (stages I/II) diffuse large B-cell non-Hodgkin lymphoma: ECOG3402

作者：Witzig Thomas E^*; Hong Fangxin; Micallef Ivana N; Gascoyne Randy D; Dogan Ahmet; Wagner Henry Jr; Kahl Brad S; Advani Ranjana H; Horning Sandra J

来源：British Journal of Haematology, 2015, 170(5): 679-686.

DOI：10.1111/bjh.13493

• radioimmunotherapy
• large cell lymphoma
• R-CHOP

Patients with early stage diffuse large B-cell lymphoma (DLBCL) receive RCHOP (rituximab cyclophosphamide, doxorubicin, vincristine, prednisone) alone or with involved field radiotherapy (IFRT). Anti-CD20 radioimmunotherapy (RIT) delivers radiation to microscopic sites outside of known disease. This phase II study aimed to achieve a functional complete response (CR) rate of 75% to RCHOP and (90)Yttrium-ibritumomab tiuxetan RIT. Patients with stages I/II DLBCL received 4-6 cycles of RCHOP followed by RIT [148MBq/kg (04mCi/kg)]; patients with positron emission tomographypositive sites of disease after RCHOP/RIT received 30Gy IFRT. Of the 62 patients enrolled; 53 were eligible. 42% (22/53) had stage I/IE; 58% (31/53) stage II/IIE. After RCHOP, 79% (42/53) were in CR/unconfirmed CR. Forty-eight patients proceeded to RIT. One partial responder after RIT received IFRT and achieved a CR. The best response after RCHOP+RIT in all 53 patients was a functional CR rate of 89% (47/53; 95% confidence interval: 77-96%). With a median follow-up of 59years, 7 (13%) patients have progressed and 4 (8%) have died (2 with DLBCL). At 5years, 78% of patients remain in remission and 94% are alive. Chemoimmunotherapy and RIT is an active regimen for early stage DLBCL patients. Eighty-nine percent of patients achieved functional CR without the requirement of IFRT. This regimen is worthy of further study for early stage DLBCL in a phase III trial.

• 出版日期2015-9