The impact of radiation therapy in patients with diffuse large B-cell lymphoma with positive post-chemotherapy FDG–PET or gallium-67 scans — Ann Oncol

The impact of radiation therapy in patients with diffuse large B-cell lymphoma with positive post-chemotherapy FDG–PET or gallium-67 scans
J. A. Dorth1, J. P. Chino1, L. R. Prosnitz1, L. F. Diehl2, A. W. Beaven2, R. E. Coleman3 and C. R. Kelsey1,*

Ann Oncol (2011) 22 (2): 405-410.
doi: 10.1093/annonc/mdq389
First published online: July 30, 2010

+ Author Affiliations
1Department of Radiation Oncology
2Department of Medicine, Division of Medical Oncology
3Department of Radiology, Division of Nuclear Medicine, Duke University Medical Center, Durham, USA

*Correspondence to: Dr C. R. Kelsey, Department of Radiation Oncology, Duke University Medical Center, 3085, Durham, NC 27710, USA. Tel: +1-919-668-5213; Fax: +1-919-668-7345; E-mail: kelse003@mc.duke.edu

Received December 9, 2009.
Revision received May 25, 2010.
Accepted May 26, 2010.

Abstract
Background: 2-[fluorine-18]fluoro-2-deoxy-D-glucose–positron emission tomography (PET) and gallium-67 citrate (gallium) response after chemotherapy are powerful prognostic factors in diffuse large B-cell lymphoma (DLBCL). However, clinical outcomes when consolidation radiation therapy (RT) is administered are less defined.

Patients and methods: We reviewed 99 patients diagnosed with DLBCL from 1996 to 2007 at Duke University who had a post-chemotherapy response assessment with either PET or gallium and who subsequently received consolidation RT. Clinical outcomes were estimated using the Kaplan–Meier method and compared using the log-rank test.

Results: Median follow-up was 4.4 years. Stage distribution was I–II in 70% and III–IV in 30%. Chemotherapy was R-CHOP or CHOP in 88%. Median RT dose was 30 Gy. Post-chemotherapy PET (n = 79) or gallium (n = 20) was positive in 21 of 99 patients and negative in 78 of 99 patients. Five-year in-field control was 95% with a negative PET/gallium scan versus 71% with a positive scan (P The impact of radiation therapy in patients with diffuse large B-cell lymphoma with positive post-chemotherapy FDG–PET or gallium-67 scans — Ann Oncol