Treatment outcome of diffuse large B-cell lymphoma involving the head and neck

Abstract

Background: This study was performed to analyze clinical features and treatment outcomes in diffuse large B-cell lymphoma (DLBCL) of head and neck and to determine the role of radiotherapy in the era of rituximab. Methods: The study assessed on the data of 56 patients diagnosed with DLBCL in head and neck treated with chemotherapy followed by radiotherapy from January 2004 to March 2016. Most of the patients were treated with R-CHOP regimen and radiotherapy was delivered to total dose of median 36 Gy. Primary endpoint was relapse-free survival (RFS) and overall survival (OS) and secondary endpoint was toxicity and pattern of relapse. Kaplan-Meier analysis with log-rank test was used for survival analyses. Results: Median and mean follow-up time was 22 and 38 months, respectively. Five-year RFS rate was 72%. There were 14 relapsed cases (25%); local relapse only in 1 patient, distant relapse only in 11 patients, and both local and distant relapse in 2 patients. Local control rate was 94%. Median OS was 80.8 months and 5-year OS was 61%. Statistically significant prognostic factors for both RFS and OS were age, performance status, IPI score and radiotherapy response. There were no differences in survival according to anatomical structures. Incidence of grade 3 and 4 hematologic toxicity was 9% and 4%, respectively. Grade 3 non-hematologic toxicity occurred in 4% and there were no grade 4 non-hematologic toxicity. Table: 332P Toxicity Grade 2 Grade 3 Grade 4 Hematologic Leucopenia 10 4 1 Anemia 2 0 0 Thrombocytopenia 1 1 1 Total 13 (23%) 5 (9%) 2 (4%) Non-hematologic Dry mouth 2 0 0 Oral mucositis 3 1 0 Esophagitis 7 0 0 General weakness 1 1 0 Total 13 (23%) 2 (4%) 0 Conclusions: Treatment outcomes ofDLBCLofhead and neck treated with chemotherapy followed by radiotherapy are satisfactory with excellent local control. Treatment toxicity was also acceptable. Therefore, radiotherapy of head and neck DLBCL is feasible and will benefit the patients even in the rituximab era.