Older patients with early-stage diffuse large B-cell lymphoma: the role of consolidation radiotherapy after chemoimmunotherapy

Abstract

The purpose of this study was to examine the association between RT and overall survival for older patients (>60 years) with early-stage diffuse large B-cell lymphoma (DLBCL) using standard and propensity score (PS)-adjusted Cox proportional hazards models. From 1998 to 2012, 2207 patients were over the age of 60 years, received chemoimmunotherapy with or without RT and were included in this study. Use of consolidation RT was associated with lower clinical stage, head/neck involved site, lack of ‘B’ symptoms, lower co-morbidity score, and higher socioeconomic status (all p < .05). Examining 1721 patients for survival outcomes (1998–2008), the 5-year overall survival for patients receiving RT was 80.1% versus 69.8% for those not receiving RT (p < .01). After PS-matching for co-variates, RT use remained associated with improved overall survival (HR = 0.63, 95% CI, 0.51–0.79, p < .01). Over the study period, RT utilization decreased from 38.5% to 28.8%. Consolidation RT was associated with improved OS for older patients with early-stage DLBCL receiving chemoimmunotherapy.

Keywords:

• Non-Hodgkin lymphoma
• elderly
• consolidation radiotherapy
• overall survival
• National Cancer Database

Acknowledgements

The data used in the study are derived from a de-identified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator.

The NCDB is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.1080/10428194.2016.1205739.