Is there a role for consolidative radiotherapy in the treatment of aggressive and localized Non-Hodgkin Lymphoma? A systematic review with meta-analysis

Table 2 Study population and therapy

Trial	Arms	N	Population	Age and PS 0-1	Stage	LDH	IPI	RT
SWOG 8736	CHOP x 8	201	WF groups D-J (DLBCL 75%); stage I to II non-bulky	> 60y = 49% 0-1 = 96%	II 33%	↑ 19%	0-1 = 71%	No RT
	CHOP x 3 + RT	200	WF groups D-J (DLBCL 75%); stage I to II non-bulky	>60y = 50% 0-1 = 97%	II 32%	↑ 20%	0-1 = 74%	IFRT 40-55 Gy
ECOG 1484	CHOP x 8	112	WF H-J (DLBCL 83%); stage I bulky to II; complete responders to CHOP only	Median 60y 0-1 = 93%	II 70% E 52%, B20%	NA	NR	No RT
	CHOP x 8 + RT	103		Median 58y 0-1 = 96%	II 68% E 45% B22%	NA	NR	IFRT 30 Gy
GELA LNH 93-1	ACVBP + CT	318	WF H-J or anaplastic according to uKC (DLBCL 81%); 15-60y; aaIPI = 0†; stages I to II	Median 46y 0-1 = 100%	II 32% E 46%	↑ 3%	0 = 96%†	No RT
	CHOP x 3 + RT	329		Median 47y 0-1 = 100%	II 32% E 52%	↑ 3%	0 = 95%†	IFRT 40 Gy
GELA LNH 93-4	CHOP x 4	277	WF H-J or anaplastic according to uKC (DLBCL 80%); >60y; aaIPI = 0†; stages I to II	Median 69y 0-1 = 99%	II 32% Bu 8%	↑ 2%	0 = 95%†	No RT
	CHOP x 4 + RT	299		Median 68y 0-1 = 99%	II 34% Bu 9%	↑ 3%	0 = 95%†	IFRT 40 Gy

Abbreviations: ACVBP + CT: doxorubicin 75 mg/m² D1 + cyclophosphamide 1200 mg/m² D1 + vindesine 2 mg/m² D1,5 + bleomycin 10 mg D1,5 and prednisone 60 mg/m² D1-5, 3 cycles with 14 days each and then consolidative chemotherapy with methotrexate, folinic acid, etoposide, ifosfamide and cytarabine; B: “B” symptoms; Bu: bulky disease; CHOP: cyclophosphamide 750 mg/m² D1 + doxorubicin 50 mg/m² D1 + vincristine 1,4 mg/m² D1 + prednisone 60 mg/m² or 100 mg D1-5, 21 day cycles; DLBCL: diffuse large B cell lymphoma; E: extranodal disease; IFRT: involved-field radiotherapy; IPI: International Prognostic Index; LDH: lactate dehydrogenase; NA: not available; NR: not reported; uKC: updated Kiel Classification; WF: Working Formulation; † age-adjusted IPI.

ISSN: 1471-2407