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Original Articles: Clinical

Radiation therapy improves survival in patients with testicular diffuse large B-cell lymphoma^*

Jennifer C. HoDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Bouthaina S. DabajaDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Sarah A. MilgromDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Grace L. SmithDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Jay P. ReddyDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Ali MazloomTacoma Valley Radiation Oncology, Tacoma, WA, USA;

Ken H. YoungDepartment of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Lijuan DengDepartment of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

L. Jeffrey MedeirosDepartment of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Wenli DongDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Pamela K. AllenDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Therese Y. AndraosDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;

Nathan H. FowlerDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

http://orcid.org/0000-0002-9494-1877

Loretta J. NastoupilDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Yasuhiro OkiDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Luis E. FayadDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Francesco TurturroDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Sattva S. NeelapuDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Jason WestinDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Fredrick B. HagemeisterDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Maria Alma RodriguezDepartment of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Chelsea C. PinnixDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Correspondence[email protected]

http://orcid.org/0000-0003-3982-3664

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Abstract

In 120 Stage I–IV testicular diffuse large B-cell lymphoma (DLBCL) patients treated from 1964 to 2015, we assessed the benefits of prophylactic contralateral testicular radiation (RT) and prophylactic central nervous system (CNS) therapy on overall, progression free, testicular relapse free, and CNS relapse free survival (OS, PFS, TRFS, and CRFS, respectively). Seventy percent of patients received RT, 53% received anthracyclines and rituximab (modern therapy), and 61% received CNS prophylaxis. On univariate analysis RT was associated with improved TRFS, PFS, and trended toward improved OS. On multivariate analysis (MVA), RT was significantly associated with improved OS and PFS; the PFS benefit persisted among patients receiving modern therapy. CNS prophylaxis was associated with improved OS, PFS, and TRFS, but not CRFS on univariate analysis, and was not significant on MVA. RT is associated with improved survival, and should be considered for all testicular DLBCL patients, but additional strategies are needed to prevent CNS relapse.

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Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2017.1312381

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Radiation therapy improves survival in patients with testicular diffuse large B-cell lymphoma^*

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Radiation therapy improves survival in patients with testicular diffuse large B-cell lymphoma*

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Radiation therapy improves survival in patients with testicular diffuse large B-cell lymphoma^*