Authors: Odejide OO, Cronin AM, Davidoff AJ, LaCasce AS, Abel GA
Title: Limited Stage Diffuse Large B-Cell Lymphoma: Comparative Effectiveness of Treatment Strategies in a Large Cohort of Elderly Patients.
Journal: Leuk Lymphoma :1-27
Date: 2014 Jun 10
Abstract: Abstract Optimal treatment for limited stage DLBCL in the elderly is controversial. Using the Surveillance Epidemiology and End Results-Medicare database, we compared overall survival (OS), time to second-line therapy (surrogate for recurrence), and adverse events in elderly patients diagnosed with stage I or II DLBCL in 1999-2009, who received either abbreviated rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) plus radiation or 6-8 cycles of RCHOP alone. Of 874 patients, 359 received abbreviated RCHOP with radiation, and 515 received a full course of RCHOP. In propensity score-adjusted analyses, OS was similar in both groups (HR 1.02, 95 CI 0.76,1.38). Abbreviated RCHOP with radiation was associated with lower risk of second-line therapy (HR 0.71, 95% CI 0.53,0.94) and lower odds of febrile neutropenia (OR 0.27, 95% CI 0.15,0.50). While the two treatments resulted in similar survival, our data suggest that abbreviated RCHOP with radiation may be better tolerated than a full course of RCHOP.
Last Modified: 03 Sep 2013