The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas.
Identifieur interne : 000318 ( PubMed/Checkpoint ); précédent : 000317; suivant : 000319The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas.
Auteurs : Niels Murawski [Allemagne] ; Gerhard Held [Allemagne] ; Marita Ziepert [Allemagne] ; Barbara Kempf [Allemagne] ; Andreas Viardot [Allemagne] ; Mathias H Nel [Allemagne] ; Mathias Witzens-Harig [Allemagne] ; Rolf Mahlberg [Allemagne] ; Christian Rübe ; Jochen Fleckenstein ; Carsten Zwick [Allemagne] ; Bertram Glass [Allemagne] ; Norbert Schmitz [Allemagne] ; Samira Zeynalova [Allemagne] ; Michael Pfreundschuh [Allemagne]Source :
- Blood [ 1528-0020 ] ; 2014.
Descripteurs français
- Wicri :
- geographic : Allemagne.
English descriptors
- KwdEn :
- Adolescent, Adult, Antibodies, Monoclonal, Murine-Derived (administration & dosage), Antineoplastic Combined Chemotherapy Protocols (administration & dosage), Central Nervous System Neoplasms (mortality), Central Nervous System Neoplasms (prevention & control), Disease-Free Survival, Facial Neoplasms (mortality), Facial Neoplasms (therapy), Female, Germany, Humans, Injections, Spinal, Lymphoma, B-Cell (mortality), Lymphoma, B-Cell (therapy), Male, Methotrexate (administration & dosage), Middle Aged, Radiotherapy, Rituximab, Skull Neoplasms (mortality), Skull Neoplasms (therapy), Survival Rate.
- MESH :
- chemical , administration & dosage : Antibodies, Monoclonal, Murine-Derived, Methotrexate.
- geographic : Germany, Rituximab.
- administration & dosage : Antineoplastic Combined Chemotherapy Protocols.
- mortality : Central Nervous System Neoplasms, Facial Neoplasms, Lymphoma, B-Cell, Skull Neoplasms.
- prevention & control : Central Nervous System Neoplasms.
- therapy : Facial Neoplasms, Lymphoma, B-Cell, Skull Neoplasms.
- Adolescent, Adult, Disease-Free Survival, Female, Humans, Injections, Spinal, Male, Middle Aged, Radiotherapy, Survival Rate.
Abstract
To define the role of radiotherapy and intrathecal prophylaxis in extralymphatic craniofacial involvement (ECFI) of aggressive B-cell lymphoma, we analyzed 11 consecutive German High-Grade Non-Hodgkin Lymphoma Study Group trials. ECFI occurred in 290/4155 (7.0%) patients (orbita, 31; paranasal sinuses, 93; main nasal cavity, 38; tongue, 27; remaining oral cavity, 99; salivary glands, 54). In a multivariable analysis adjusted for International Prognostic Index rituximab improved event-free and overall survival both in patients with and without ECFI. Three-year event-free (79% vs 79%; P = .842) and overall survival (86% vs 88%; P = .351) rates were similar in 145 patients receiving and 57 not receiving radiotherapy. Without rituximab, the 2-year cumulative rate of central nervous system (CNS) disease was increased in 205 ECFI patients compared with 2586 non-ECFI patients (4.2% vs 2.8%; P = .038), whereas this was not observed with rituximab (1.6% in 83 ECFI vs 3.4% in 1252 non-ECFI patients; P = .682). In 88 ECFI patients who received intrathecal prophylaxis with methotrexate, the 2-year rate of CNS disease was 4.2% compared with 2.3% in 191 patients who did not (P = .981). In conclusion, rituximab eliminates the increased risk for CNS disease in patients with ECFI. This retrospective analysis does not support intrathecal prophylaxis or radiotherapy to ECFI patients in complete remission/unconfirmed complete remission. These findings should be confirmed in a prospective study.
DOI: 10.1182/blood-2013-10-535021
PubMed: 24939657
Affiliations:
- Allemagne
- Bade-Wurtemberg, District de Karlsruhe, District de Leipzig, District de Tübingen, Hambourg, Saxe (Land)
- Hambourg, Heidelberg, Leipzig, Ulm
Links toward previous steps (curation, corpus...)
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pubmed:24939657Le document en format XML
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<author><name sortKey="Mahlberg, Rolf" sort="Mahlberg, Rolf" uniqKey="Mahlberg R" first="Rolf" last="Mahlberg">Rolf Mahlberg</name>
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<term>Antineoplastic Combined Chemotherapy Protocols (administration & dosage)</term>
<term>Central Nervous System Neoplasms (mortality)</term>
<term>Central Nervous System Neoplasms (prevention & control)</term>
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<term>Survival Rate</term>
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<term>Skull Neoplasms</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Disease-Free Survival</term>
<term>Female</term>
<term>Humans</term>
<term>Injections, Spinal</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Radiotherapy</term>
<term>Survival Rate</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Allemagne</term>
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<front><div type="abstract" xml:lang="en">To define the role of radiotherapy and intrathecal prophylaxis in extralymphatic craniofacial involvement (ECFI) of aggressive B-cell lymphoma, we analyzed 11 consecutive German High-Grade Non-Hodgkin Lymphoma Study Group trials. ECFI occurred in 290/4155 (7.0%) patients (orbita, 31; paranasal sinuses, 93; main nasal cavity, 38; tongue, 27; remaining oral cavity, 99; salivary glands, 54). In a multivariable analysis adjusted for International Prognostic Index rituximab improved event-free and overall survival both in patients with and without ECFI. Three-year event-free (79% vs 79%; P = .842) and overall survival (86% vs 88%; P = .351) rates were similar in 145 patients receiving and 57 not receiving radiotherapy. Without rituximab, the 2-year cumulative rate of central nervous system (CNS) disease was increased in 205 ECFI patients compared with 2586 non-ECFI patients (4.2% vs 2.8%; P = .038), whereas this was not observed with rituximab (1.6% in 83 ECFI vs 3.4% in 1252 non-ECFI patients; P = .682). In 88 ECFI patients who received intrathecal prophylaxis with methotrexate, the 2-year rate of CNS disease was 4.2% compared with 2.3% in 191 patients who did not (P = .981). In conclusion, rituximab eliminates the increased risk for CNS disease in patients with ECFI. This retrospective analysis does not support intrathecal prophylaxis or radiotherapy to ECFI patients in complete remission/unconfirmed complete remission. These findings should be confirmed in a prospective study.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24939657</PMID>
<DateCreated><Year>2014</Year>
<Month>08</Month>
<Day>01</Day>
</DateCreated>
<DateCompleted><Year>2014</Year>
<Month>09</Month>
<Day>29</Day>
</DateCompleted>
<DateRevised><Year>2015</Year>
<Month>11</Month>
<Day>19</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1528-0020</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>124</Volume>
<Issue>5</Issue>
<PubDate><Year>2014</Year>
<Month>Jul</Month>
<Day>31</Day>
</PubDate>
</JournalIssue>
<Title>Blood</Title>
<ISOAbbreviation>Blood</ISOAbbreviation>
</Journal>
<ArticleTitle>The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas.</ArticleTitle>
<Pagination><MedlinePgn>720-8</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1182/blood-2013-10-535021</ELocationID>
<Abstract><AbstractText>To define the role of radiotherapy and intrathecal prophylaxis in extralymphatic craniofacial involvement (ECFI) of aggressive B-cell lymphoma, we analyzed 11 consecutive German High-Grade Non-Hodgkin Lymphoma Study Group trials. ECFI occurred in 290/4155 (7.0%) patients (orbita, 31; paranasal sinuses, 93; main nasal cavity, 38; tongue, 27; remaining oral cavity, 99; salivary glands, 54). In a multivariable analysis adjusted for International Prognostic Index rituximab improved event-free and overall survival both in patients with and without ECFI. Three-year event-free (79% vs 79%; P = .842) and overall survival (86% vs 88%; P = .351) rates were similar in 145 patients receiving and 57 not receiving radiotherapy. Without rituximab, the 2-year cumulative rate of central nervous system (CNS) disease was increased in 205 ECFI patients compared with 2586 non-ECFI patients (4.2% vs 2.8%; P = .038), whereas this was not observed with rituximab (1.6% in 83 ECFI vs 3.4% in 1252 non-ECFI patients; P = .682). In 88 ECFI patients who received intrathecal prophylaxis with methotrexate, the 2-year rate of CNS disease was 4.2% compared with 2.3% in 191 patients who did not (P = .981). In conclusion, rituximab eliminates the increased risk for CNS disease in patients with ECFI. This retrospective analysis does not support intrathecal prophylaxis or radiotherapy to ECFI patients in complete remission/unconfirmed complete remission. These findings should be confirmed in a prospective study.</AbstractText>
<CopyrightInformation>© 2014 by The American Society of Hematology.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Murawski</LastName>
<ForeName>Niels</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Klinik Innere Medizin I, Saarland University Medical School, Hamburg, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Held</LastName>
<ForeName>Gerhard</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Klinik Innere Medizin I, Saarland University Medical School, Hamburg, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ziepert</LastName>
<ForeName>Marita</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kempf</LastName>
<ForeName>Barbara</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Klinikum Landshut, Landshut, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Viardot</LastName>
<ForeName>Andreas</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Universitätsklinikum Ulm, Ulm, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hänel</LastName>
<ForeName>Mathias</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Klinikum Chemnitz, Chemnitz, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Witzens-Harig</LastName>
<ForeName>Mathias</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Medizinische Klinik V, Heidelberg University, Heidelberg, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mahlberg</LastName>
<ForeName>Rolf</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Klinikum Mutterhaus der Borromäerinnen, Trier, Trier, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rübe</LastName>
<ForeName>Christian</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Klinik für Strahlentherapie, Saarland University Medical School, Hamburg, Germany; and.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fleckenstein</LastName>
<ForeName>Jochen</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Klinik für Strahlentherapie, Saarland University Medical School, Hamburg, Germany; and.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zwick</LastName>
<ForeName>Carsten</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Klinik Innere Medizin I, Saarland University Medical School, Hamburg, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Glass</LastName>
<ForeName>Bertram</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Asklepios-Klinik St. Georg, Hamburg, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Schmitz</LastName>
<ForeName>Norbert</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Asklepios-Klinik St. Georg, Hamburg, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zeynalova</LastName>
<ForeName>Samira</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany;</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pfreundschuh</LastName>
<ForeName>Michael</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Klinik Innere Medizin I, Saarland University Medical School, Hamburg, Germany;</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D017426">Clinical Trial, Phase I</PublicationType>
<PublicationType UI="D017427">Clinical Trial, Phase II</PublicationType>
<PublicationType UI="D003160">Comparative Study</PublicationType>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D016449">Randomized Controlled Trial</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2014</Year>
<Month>06</Month>
<Day>17</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Blood</MedlineTA>
<NlmUniqueID>7603509</NlmUniqueID>
<ISSNLinking>0006-4971</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D058846">Antibodies, Monoclonal, Murine-Derived</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>4F4X42SYQ6</RegistryNumber>
<NameOfSubstance UI="D000069283">Rituximab</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>YL5FZ2Y5U1</RegistryNumber>
<NameOfSubstance UI="D008727">Methotrexate</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058846" MajorTopicYN="N">Antibodies, Monoclonal, Murine-Derived</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000971" MajorTopicYN="N">Antineoplastic Combined Chemotherapy Protocols</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016543" MajorTopicYN="Y">Central Nervous System Neoplasms</DescriptorName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018572" MajorTopicYN="N">Disease-Free Survival</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005153" MajorTopicYN="Y">Facial Neoplasms</DescriptorName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N" Type="Geographic">Germany</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007278" MajorTopicYN="N">Injections, Spinal</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016393" MajorTopicYN="Y">Lymphoma, B-Cell</DescriptorName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008727" MajorTopicYN="N">Methotrexate</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011878" MajorTopicYN="Y">Radiotherapy</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000069283" MajorTopicYN="N">Rituximab</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012888" MajorTopicYN="Y">Skull Neoplasms</DescriptorName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015996" MajorTopicYN="N">Survival Rate</DescriptorName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2014</Year>
<Month>6</Month>
<Day>19</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="pubmed"><Year>2014</Year>
<Month>6</Month>
<Day>19</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="medline"><Year>2014</Year>
<Month>9</Month>
<Day>30</Day>
<Hour>6</Hour>
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<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">24939657</ArticleId>
<ArticleId IdType="pii">blood-2013-10-535021</ArticleId>
<ArticleId IdType="doi">10.1182/blood-2013-10-535021</ArticleId>
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<affiliations><list><country><li>Allemagne</li>
</country>
<region><li>Bade-Wurtemberg</li>
<li>District de Karlsruhe</li>
<li>District de Leipzig</li>
<li>District de Tübingen</li>
<li>Hambourg</li>
<li>Saxe (Land)</li>
</region>
<settlement><li>Hambourg</li>
<li>Heidelberg</li>
<li>Leipzig</li>
<li>Ulm</li>
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</list>
<tree><noCountry><name sortKey="Fleckenstein, Jochen" sort="Fleckenstein, Jochen" uniqKey="Fleckenstein J" first="Jochen" last="Fleckenstein">Jochen Fleckenstein</name>
<name sortKey="Rube, Christian" sort="Rube, Christian" uniqKey="Rube C" first="Christian" last="Rübe">Christian Rübe</name>
</noCountry>
<country name="Allemagne"><region name="Hambourg"><name sortKey="Murawski, Niels" sort="Murawski, Niels" uniqKey="Murawski N" first="Niels" last="Murawski">Niels Murawski</name>
</region>
<name sortKey="Glass, Bertram" sort="Glass, Bertram" uniqKey="Glass B" first="Bertram" last="Glass">Bertram Glass</name>
<name sortKey="H Nel, Mathias" sort="H Nel, Mathias" uniqKey="H Nel M" first="Mathias" last="H Nel">Mathias H Nel</name>
<name sortKey="Held, Gerhard" sort="Held, Gerhard" uniqKey="Held G" first="Gerhard" last="Held">Gerhard Held</name>
<name sortKey="Kempf, Barbara" sort="Kempf, Barbara" uniqKey="Kempf B" first="Barbara" last="Kempf">Barbara Kempf</name>
<name sortKey="Mahlberg, Rolf" sort="Mahlberg, Rolf" uniqKey="Mahlberg R" first="Rolf" last="Mahlberg">Rolf Mahlberg</name>
<name sortKey="Pfreundschuh, Michael" sort="Pfreundschuh, Michael" uniqKey="Pfreundschuh M" first="Michael" last="Pfreundschuh">Michael Pfreundschuh</name>
<name sortKey="Schmitz, Norbert" sort="Schmitz, Norbert" uniqKey="Schmitz N" first="Norbert" last="Schmitz">Norbert Schmitz</name>
<name sortKey="Viardot, Andreas" sort="Viardot, Andreas" uniqKey="Viardot A" first="Andreas" last="Viardot">Andreas Viardot</name>
<name sortKey="Witzens Harig, Mathias" sort="Witzens Harig, Mathias" uniqKey="Witzens Harig M" first="Mathias" last="Witzens-Harig">Mathias Witzens-Harig</name>
<name sortKey="Zeynalova, Samira" sort="Zeynalova, Samira" uniqKey="Zeynalova S" first="Samira" last="Zeynalova">Samira Zeynalova</name>
<name sortKey="Ziepert, Marita" sort="Ziepert, Marita" uniqKey="Ziepert M" first="Marita" last="Ziepert">Marita Ziepert</name>
<name sortKey="Zwick, Carsten" sort="Zwick, Carsten" uniqKey="Zwick C" first="Carsten" last="Zwick">Carsten Zwick</name>
</country>
</tree>
</affiliations>
</record>
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