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Shu-lian Wang - One of the best experts on this subject based on the ideXlab platform.
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dosimetric and clinical outcomes with intensity modulated radiation therapy after chemotherapy for patients with early stage diffuse large b cell lymphoma of Waldeyer Ring
International Journal of Radiation Oncology Biology Physics, 2016Co-Authors: Shu-lian Wang, Weihu Wang, Jing Jin, Yongwen Song, Yueping Liu, Hui Fang, Hua Ren, Bo Chen, Mei Dong, Yuan TangAbstract:Purpose To assess the dosimetric benefit, prognosis, and toxicity of intensity modulated radiation therapy (IMRT) for early-stage, diffuse large B-cell lymphoma of Waldeyer Ring (WR-DLBCL). Methods and Materials Sixty-one patients with early-stage WR-DLBCL who received chemotherapy followed by IMRT were retrospectively reviewed. Dosimetric parameters for the target volume and critical normal structures were evaluated, and survival was calculated. Linear regression analysis was used to assess the effect of the mean dose (D mean ) to the parotid glands on xerostomia. Results The median conformity index and homogeneity index of the planning target volume (PTV) were 0.83 and 0.90, respectively, demonstrating very good coverage of the target volume. The mean dose to the parotid glands was 24.9 Gy. The 5-year overall survival (OS), progression-free survival (PFS), and locoregional control (LRC) were 94.7%, 93.1%, and 98.3%, respectively. Early and late toxicities were mild, and no patient experienced late grade ≥3 toxicities. The D mean to the parotid glands had a linear correlation with late grade ≥2 xerostomia. Conclusions IMRT after chemotherapy can provide excellent dose conformity and achieve favorable survival and LRC with mild toxicities in patients with early-stage WR-DLBCL. Dose constraints for the parotid glands should be limited to
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Value of radiotherapy for early-stage Waldeyer’s Ring diffuse large B-cell lymphoma in the rituximab era
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the value of radiotherapy following rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based chemotherapy for patients with early-stage Waldeyer’s Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods Eighty-three patients diagnosed with early-stage WR-DLBCL who were admitted to our hospital from 2000 to 2013 were enrolled in the study. In these patients, twenty-five had stage Ⅰ disease and fifty-eight had stage Ⅱ disease. All patients received R-CHOP-based chemotherapy with (n=62) or without (n=21) involved-field radiotherapy (Waldeyer’s Ring plus cervical lymph nodes). The overall survival (OS), progression-free survival (PFS), and local-regional control (LRC) rates were calculated using the Kaplan-Meier method. The univariate analysis was performed using the log-rank method. The multivariate analysis was performed using the Cox regression model. Results In all patients, the 5-year sample size was 18; the 5-year OS, PFS, and LRC rates were 89%, 84%, and 90%, respectively. According to the univariate analysis, patient age greater than 60 years, an increased lactate dehydrogenase level, Eastern Cooperative Oncology Group (ECOG) performance status no less than 2, and International Prognostic Index (IPI) no less than 2 were poor prognostic factors. Patient age greater than 60 years, a tumor size no less than 5 cm, ECOG performance status no less than 2, and IPI no less than 2 were influencing factors for PFS and LRC rates. In addition to the treatment with rituximab, patients treated with consolidative radiotherapy had significantly higher PFS and LRC rates (94% vs. 58%, P=0.003; 100% vs. 61%, P=0.000) as well as slightly higher OS rate (94% vs. 71%, P=0.063) than those treated without radiotherapy. Conclusions Consolidative radiotherapy following R-CHOP-based chemotherapy significantly improves PFS, LRC, and probably OS rates for early-stage WR-DLBCL. This conclusion still needs to be confirmed by prospective studies with a large sample size. Key words: Waldeyer Ring diffuse large B-cell lymphoma/radiotherapy; Waldeyer Ring diffuse large B-cell lymphoma/chemotherapy; Rituximab
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value of radiotherapy for early stage Waldeyer s Ring diffuse large b cell lymphoma in the rituximab era
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the value of radiotherapy following rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based chemotherapy for patients with early-stage Waldeyer’s Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods Eighty-three patients diagnosed with early-stage WR-DLBCL who were admitted to our hospital from 2000 to 2013 were enrolled in the study. In these patients, twenty-five had stage Ⅰ disease and fifty-eight had stage Ⅱ disease. All patients received R-CHOP-based chemotherapy with (n=62) or without (n=21) involved-field radiotherapy (Waldeyer’s Ring plus cervical lymph nodes). The overall survival (OS), progression-free survival (PFS), and local-regional control (LRC) rates were calculated using the Kaplan-Meier method. The univariate analysis was performed using the log-rank method. The multivariate analysis was performed using the Cox regression model. Results In all patients, the 5-year sample size was 18; the 5-year OS, PFS, and LRC rates were 89%, 84%, and 90%, respectively. According to the univariate analysis, patient age greater than 60 years, an increased lactate dehydrogenase level, Eastern Cooperative Oncology Group (ECOG) performance status no less than 2, and International Prognostic Index (IPI) no less than 2 were poor prognostic factors. Patient age greater than 60 years, a tumor size no less than 5 cm, ECOG performance status no less than 2, and IPI no less than 2 were influencing factors for PFS and LRC rates. In addition to the treatment with rituximab, patients treated with consolidative radiotherapy had significantly higher PFS and LRC rates (94% vs. 58%, P=0.003; 100% vs. 61%, P=0.000) as well as slightly higher OS rate (94% vs. 71%, P=0.063) than those treated without radiotherapy. Conclusions Consolidative radiotherapy following R-CHOP-based chemotherapy significantly improves PFS, LRC, and probably OS rates for early-stage WR-DLBCL. This conclusion still needs to be confirmed by prospective studies with a large sample size. Key words: Waldeyer Ring diffuse large B-cell lymphoma/radiotherapy; Waldeyer Ring diffuse large B-cell lymphoma/chemotherapy; Rituximab
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clinical outcome and prognosis of Waldeyer s Ring diffuse large b cell lymphoma an analysis of 200 patients
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the clinical features, treatment outcome, and prognostic factors in patients with primary Waldeyer' s Ring diffuse large B-cell lymphoma(WR-DLBCL). Methods This study included 200 patients with a confirmed diagnosis of primary WR-DLBCL admitted to our hospital from 2000 to 2013, who consisted of 50 stage I patients, 125 stage Ⅱ patients, and 25 stage Ⅲ-Ⅳ patients. Most patients received 4-6 cycles of CHOP or CHOP-based chemotherapy with or without involved field radiotherapy(Waldeyer's Ring+cervical lymph node region). Results The 5-year sample size was 71. The 5-year overall survival(OS), progression-free survival(PFS), and locoregional control(LRC)rates for the whole group were 78%, 72%, and 87%, respectively. In the 175 early stage patients, chemoradiotherapy resulted in significantly higher OS, PFS, and LRC than chemotherapy alone(86% vs. 70%, P= 0. 001 ; 84% vs. 58%, P= 0. 000; 97% vs. 66%,P=0. 000). Univariate analysis showed that age, tumor size, stage, lactate dehydrogenase leve, and International Prognostic Index were prognostic factors for OS, PFS, and LRC(P=0. 000-0. 036), while the prognostic factors for PFS also included Eastern Cooperative Oncology Group score and cervical nodal involvement(P = 0. 018). Multivariate analysis showed that age and stage were prognostic factors for OS and LRC(P=0. 003-0. 022), and age was the prognostic factor for PFS(P= 0. 000). Conclusions WR-DLBCL has distinct clinical features and favorable prognoses. For early stage patients, combined-modality therapy results in significantly higher OS, PFS, and LRC. Key words: Diffuse large B-cell lymphoma, Waldeyer Ring/chemoradiotherapy; Prognosis
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clinical disparity and favorable prognoses for patients with Waldeyer Ring extranodal nasal type nk t cell lymphoma and diffuse large b cell lymphoma
American Journal of Clinical Oncology, 2014Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Qingfeng Liu, Zhao-yang Wang, Hui Fang, Hua Ren, Bo ChenAbstract:Objectives: This study aimed to compare the clinical characteristics and prognosis of Waldeyer Ring extranodal nasal-type natural killer (NK)/T-cell lymphoma (WR-NKTCL) and Waldeyer Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods: Consecutive diagnoses of 122 WR-DLBCL and 44 WR-NKTCL patients, receiving mainly primary radiotherapy in early-stage WR-NKTCL and primary chemotherapy in early-stage WR-DLBCL, were reviewed. Results: WR-NKTCL occurred predominately in young males, as nasopharyngeal stage I disease with B-symptoms, extranodal dissemination, and involving adjacent structures. WR-DLBCL was mainly stage II tonsillar disease with regional lymph node involvement. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 74% and 67% in WR-DLBCL, respectively, and 68% (P=0.468) and 59% (P=0.303) in WR-NKTCL. In stages I and II disease, WR-DLBCL 5-year OS and PFS were 79% and 76% compared with 72% (P=0.273) and 62% (P=0.117) in WR-NKTCL. In stage I disease, WR-DLBCL 5-year OS and PFS were 81% and 81%, compared with 76% (P=0.394) and 63% (P=0.236) in WR-NKTCL. In addition, the prognostic factors and failure patterns in WR-DLBCL and WR-NKTCL differed substantially. Conclusions: These results indicate that remarkable clinical disparities exist between WR-DLBCL and WR-NKTCL; however, different treatment strategies for each can result in similarly favorable prognoses.
Yuan Zhu - One of the best experts on this subject based on the ideXlab platform.
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Radiotherapy for nasal cavity and Waldeyer Ring natural killer/T-cell lymphoma: Analysis in 131 patients.
Journal of Clinical Oncology, 2013Co-Authors: Yuan Zhu, Luying Liu, Jialing LuoAbstract:8553 Background: Theaim of this study was to evaluate the efficacy and prognosis of chemotherapy and radiotherapy for patients with nasal cavity and Waldeyer Ring natural killer/T cell lymphoma. Methods: Records of 131 patients who received chemotherapy or radiotherapy or chemoradiotherapy at Zhejiang Cancer Hospital between 2000 and 2010, were retrospectively reviewed. Ninety-eight patients received chemoradiotherapy. Thirty patients received radiotherapy, and three patients received chemotherapy. All patients had pathology and immunohistochemistry diagnosis. According to the Ann Arbor Staging System, majority of patients were staged as IE stage (116/131). 14 patients presented with IIE stage, and 1 IIIE stage. Thirty-four patients had B symptoms. Results: 109 patients were with nasal cavity NK/T cell lymphoma, and 22 patients with Waldeyer Ring NK/T cell lymphoma. Complete response (CR) was achieved in 116 (89%) patients. The 5-year overall survival (OS) rate and disease-free survival (DFS) rate for all...
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radiotherapy for nasal cavity and Waldeyer Ring natural killer t cell lymphoma analysis in 131 patients
Journal of Clinical Oncology, 2013Co-Authors: Yuan Zhu, Luying Liu, Jialing LuoAbstract:8553 Background: Theaim of this study was to evaluate the efficacy and prognosis of chemotherapy and radiotherapy for patients with nasal cavity and Waldeyer Ring natural killer/T cell lymphoma. Methods: Records of 131 patients who received chemotherapy or radiotherapy or chemoradiotherapy at Zhejiang Cancer Hospital between 2000 and 2010, were retrospectively reviewed. Ninety-eight patients received chemoradiotherapy. Thirty patients received radiotherapy, and three patients received chemotherapy. All patients had pathology and immunohistochemistry diagnosis. According to the Ann Arbor Staging System, majority of patients were staged as IE stage (116/131). 14 patients presented with IIE stage, and 1 IIIE stage. Thirty-four patients had B symptoms. Results: 109 patients were with nasal cavity NK/T cell lymphoma, and 22 patients with Waldeyer Ring NK/T cell lymphoma. Complete response (CR) was achieved in 116 (89%) patients. The 5-year overall survival (OS) rate and disease-free survival (DFS) rate for all...
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Prognostic analysis of 130 patients with nasal and Waldeyer Ring NK/T cell lymphoma treated by radiotherapy and/or chemotherapy
Chinese Journal of Radiation Oncology, 2013Co-Authors: Jia-lin Luo, Luying Liu, Yuan ZhuAbstract:Objective To observe the clinical effects of radiotherapy and/or chemotherapy in the treatment of nasal and Waldeyer Ring natural killer (NK)/T cell lymphoma and to analyze the prognostic factors.Methods Between January 20,2000 and December 21,2010,109 patients with nasal NK/T cell lymphoma and 21 patients with Waldeyer Ring NK/T cell lymphoma were admitted to our hospital; the diagnosis was confirmed by immunohistochemistry.According to the Ann Arbor staging system,116 patients were classified as stage Ⅰ E,and 14 as stage Ⅱ E.Thirty patients received radiotherapy alone;2 patients received chemotherapy alone; 98 patients received radiochemotherapy.Results The follow-up rate was 100％.Seventy-eight patients were followed up for at least 5 years.The complete remission (CR) rate was 89.2％ in all patients.The CR rates of stage Ⅰ E patients and stage Ⅱ E patients were 88.8％ and 92.9％,respectively (x2 =0.02,P =0.837).The CR rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 86％ and 96％,respectively (x2 =1.44,P =0.230).The five-year overall survival (OS) rate and disease-free survival (DFS) rate of all patients were 58.0％ and 57.2％,respectively.The five-year OS rates of stage Ⅰ E patients and stage Ⅱ E patients were 60.6％ and 36.3％,respectively (x2 =0.25,P =0.615) ;the five-year DFS rates of stage Ⅰ E patients and stage Ⅱ E patients were 59.7％ and 36.3％,respectively (x2 =0.21,P =0.648).The five-year OS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 70.0％ and 48.4％,respectively (x2 =0.01,P =0.933) ; the five-year DFS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 65.6％ and 48.4％,respectively (x2 =0.09,P =0.764).The grade 3-4 toxicity rates of radiotherapy alone and radiochemotherapy were 6.7％ and 54.1％,respectively (x2 =41.38,P=0.002).The radiation dose to the primary lesion and Eastern Cooperative Oncology Group (ECOG) score were correlated with OS (x2 =3.1 8,P =0.005 ; x2 =2.97,P =0.008).Conclusions The clinical effect of radiochemotherapy is similar to that of radiotherapy alone in the patients with stage ⅠE and ⅡE nasal and Waldeyer Ring NK/T cell lymphoma,but radiochemotherapy has higher toxicity than radiotherapy alone.The radiation dose to the primary lesion and ECOG score are the influential factors for OS. Key words: Nasal cavity lymphoma/radiochemotherapy; Waldeyer Ring lymphoma/radiochemotherapy ; Lymphoma, natural killer/T cell; Prognosis
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prognostic analysis of 130 patients with nasal and Waldeyer Ring nk t cell lymphoma treated by radiotherapy and or chemotherapy
Chinese Journal of Radiation Oncology, 2013Co-Authors: Jia-lin Luo, Luying Liu, Yuan ZhuAbstract:Objective To observe the clinical effects of radiotherapy and/or chemotherapy in the treatment of nasal and Waldeyer Ring natural killer (NK)/T cell lymphoma and to analyze the prognostic factors.Methods Between January 20,2000 and December 21,2010,109 patients with nasal NK/T cell lymphoma and 21 patients with Waldeyer Ring NK/T cell lymphoma were admitted to our hospital; the diagnosis was confirmed by immunohistochemistry.According to the Ann Arbor staging system,116 patients were classified as stage Ⅰ E,and 14 as stage Ⅱ E.Thirty patients received radiotherapy alone;2 patients received chemotherapy alone; 98 patients received radiochemotherapy.Results The follow-up rate was 100％.Seventy-eight patients were followed up for at least 5 years.The complete remission (CR) rate was 89.2％ in all patients.The CR rates of stage Ⅰ E patients and stage Ⅱ E patients were 88.8％ and 92.9％,respectively (x2 =0.02,P =0.837).The CR rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 86％ and 96％,respectively (x2 =1.44,P =0.230).The five-year overall survival (OS) rate and disease-free survival (DFS) rate of all patients were 58.0％ and 57.2％,respectively.The five-year OS rates of stage Ⅰ E patients and stage Ⅱ E patients were 60.6％ and 36.3％,respectively (x2 =0.25,P =0.615) ;the five-year DFS rates of stage Ⅰ E patients and stage Ⅱ E patients were 59.7％ and 36.3％,respectively (x2 =0.21,P =0.648).The five-year OS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 70.0％ and 48.4％,respectively (x2 =0.01,P =0.933) ; the five-year DFS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 65.6％ and 48.4％,respectively (x2 =0.09,P =0.764).The grade 3-4 toxicity rates of radiotherapy alone and radiochemotherapy were 6.7％ and 54.1％,respectively (x2 =41.38,P=0.002).The radiation dose to the primary lesion and Eastern Cooperative Oncology Group (ECOG) score were correlated with OS (x2 =3.1 8,P =0.005 ; x2 =2.97,P =0.008).Conclusions The clinical effect of radiochemotherapy is similar to that of radiotherapy alone in the patients with stage ⅠE and ⅡE nasal and Waldeyer Ring NK/T cell lymphoma,but radiochemotherapy has higher toxicity than radiotherapy alone.The radiation dose to the primary lesion and ECOG score are the influential factors for OS. Key words: Nasal cavity lymphoma/radiochemotherapy; Waldeyer Ring lymphoma/radiochemotherapy ; Lymphoma, natural killer/T cell; Prognosis
Weihu Wang - One of the best experts on this subject based on the ideXlab platform.
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dosimetric and clinical outcomes with intensity modulated radiation therapy after chemotherapy for patients with early stage diffuse large b cell lymphoma of Waldeyer Ring
International Journal of Radiation Oncology Biology Physics, 2016Co-Authors: Shu-lian Wang, Weihu Wang, Jing Jin, Yongwen Song, Yueping Liu, Hui Fang, Hua Ren, Bo Chen, Mei Dong, Yuan TangAbstract:Purpose To assess the dosimetric benefit, prognosis, and toxicity of intensity modulated radiation therapy (IMRT) for early-stage, diffuse large B-cell lymphoma of Waldeyer Ring (WR-DLBCL). Methods and Materials Sixty-one patients with early-stage WR-DLBCL who received chemotherapy followed by IMRT were retrospectively reviewed. Dosimetric parameters for the target volume and critical normal structures were evaluated, and survival was calculated. Linear regression analysis was used to assess the effect of the mean dose (D mean ) to the parotid glands on xerostomia. Results The median conformity index and homogeneity index of the planning target volume (PTV) were 0.83 and 0.90, respectively, demonstrating very good coverage of the target volume. The mean dose to the parotid glands was 24.9 Gy. The 5-year overall survival (OS), progression-free survival (PFS), and locoregional control (LRC) were 94.7%, 93.1%, and 98.3%, respectively. Early and late toxicities were mild, and no patient experienced late grade ≥3 toxicities. The D mean to the parotid glands had a linear correlation with late grade ≥2 xerostomia. Conclusions IMRT after chemotherapy can provide excellent dose conformity and achieve favorable survival and LRC with mild toxicities in patients with early-stage WR-DLBCL. Dose constraints for the parotid glands should be limited to
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Value of radiotherapy for early-stage Waldeyer’s Ring diffuse large B-cell lymphoma in the rituximab era
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the value of radiotherapy following rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based chemotherapy for patients with early-stage Waldeyer’s Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods Eighty-three patients diagnosed with early-stage WR-DLBCL who were admitted to our hospital from 2000 to 2013 were enrolled in the study. In these patients, twenty-five had stage Ⅰ disease and fifty-eight had stage Ⅱ disease. All patients received R-CHOP-based chemotherapy with (n=62) or without (n=21) involved-field radiotherapy (Waldeyer’s Ring plus cervical lymph nodes). The overall survival (OS), progression-free survival (PFS), and local-regional control (LRC) rates were calculated using the Kaplan-Meier method. The univariate analysis was performed using the log-rank method. The multivariate analysis was performed using the Cox regression model. Results In all patients, the 5-year sample size was 18; the 5-year OS, PFS, and LRC rates were 89%, 84%, and 90%, respectively. According to the univariate analysis, patient age greater than 60 years, an increased lactate dehydrogenase level, Eastern Cooperative Oncology Group (ECOG) performance status no less than 2, and International Prognostic Index (IPI) no less than 2 were poor prognostic factors. Patient age greater than 60 years, a tumor size no less than 5 cm, ECOG performance status no less than 2, and IPI no less than 2 were influencing factors for PFS and LRC rates. In addition to the treatment with rituximab, patients treated with consolidative radiotherapy had significantly higher PFS and LRC rates (94% vs. 58%, P=0.003; 100% vs. 61%, P=0.000) as well as slightly higher OS rate (94% vs. 71%, P=0.063) than those treated without radiotherapy. Conclusions Consolidative radiotherapy following R-CHOP-based chemotherapy significantly improves PFS, LRC, and probably OS rates for early-stage WR-DLBCL. This conclusion still needs to be confirmed by prospective studies with a large sample size. Key words: Waldeyer Ring diffuse large B-cell lymphoma/radiotherapy; Waldeyer Ring diffuse large B-cell lymphoma/chemotherapy; Rituximab
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value of radiotherapy for early stage Waldeyer s Ring diffuse large b cell lymphoma in the rituximab era
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the value of radiotherapy following rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based chemotherapy for patients with early-stage Waldeyer’s Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods Eighty-three patients diagnosed with early-stage WR-DLBCL who were admitted to our hospital from 2000 to 2013 were enrolled in the study. In these patients, twenty-five had stage Ⅰ disease and fifty-eight had stage Ⅱ disease. All patients received R-CHOP-based chemotherapy with (n=62) or without (n=21) involved-field radiotherapy (Waldeyer’s Ring plus cervical lymph nodes). The overall survival (OS), progression-free survival (PFS), and local-regional control (LRC) rates were calculated using the Kaplan-Meier method. The univariate analysis was performed using the log-rank method. The multivariate analysis was performed using the Cox regression model. Results In all patients, the 5-year sample size was 18; the 5-year OS, PFS, and LRC rates were 89%, 84%, and 90%, respectively. According to the univariate analysis, patient age greater than 60 years, an increased lactate dehydrogenase level, Eastern Cooperative Oncology Group (ECOG) performance status no less than 2, and International Prognostic Index (IPI) no less than 2 were poor prognostic factors. Patient age greater than 60 years, a tumor size no less than 5 cm, ECOG performance status no less than 2, and IPI no less than 2 were influencing factors for PFS and LRC rates. In addition to the treatment with rituximab, patients treated with consolidative radiotherapy had significantly higher PFS and LRC rates (94% vs. 58%, P=0.003; 100% vs. 61%, P=0.000) as well as slightly higher OS rate (94% vs. 71%, P=0.063) than those treated without radiotherapy. Conclusions Consolidative radiotherapy following R-CHOP-based chemotherapy significantly improves PFS, LRC, and probably OS rates for early-stage WR-DLBCL. This conclusion still needs to be confirmed by prospective studies with a large sample size. Key words: Waldeyer Ring diffuse large B-cell lymphoma/radiotherapy; Waldeyer Ring diffuse large B-cell lymphoma/chemotherapy; Rituximab
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clinical outcome and prognosis of Waldeyer s Ring diffuse large b cell lymphoma an analysis of 200 patients
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the clinical features, treatment outcome, and prognostic factors in patients with primary Waldeyer' s Ring diffuse large B-cell lymphoma(WR-DLBCL). Methods This study included 200 patients with a confirmed diagnosis of primary WR-DLBCL admitted to our hospital from 2000 to 2013, who consisted of 50 stage I patients, 125 stage Ⅱ patients, and 25 stage Ⅲ-Ⅳ patients. Most patients received 4-6 cycles of CHOP or CHOP-based chemotherapy with or without involved field radiotherapy(Waldeyer's Ring+cervical lymph node region). Results The 5-year sample size was 71. The 5-year overall survival(OS), progression-free survival(PFS), and locoregional control(LRC)rates for the whole group were 78%, 72%, and 87%, respectively. In the 175 early stage patients, chemoradiotherapy resulted in significantly higher OS, PFS, and LRC than chemotherapy alone(86% vs. 70%, P= 0. 001 ; 84% vs. 58%, P= 0. 000; 97% vs. 66%,P=0. 000). Univariate analysis showed that age, tumor size, stage, lactate dehydrogenase leve, and International Prognostic Index were prognostic factors for OS, PFS, and LRC(P=0. 000-0. 036), while the prognostic factors for PFS also included Eastern Cooperative Oncology Group score and cervical nodal involvement(P = 0. 018). Multivariate analysis showed that age and stage were prognostic factors for OS and LRC(P=0. 003-0. 022), and age was the prognostic factor for PFS(P= 0. 000). Conclusions WR-DLBCL has distinct clinical features and favorable prognoses. For early stage patients, combined-modality therapy results in significantly higher OS, PFS, and LRC. Key words: Diffuse large B-cell lymphoma, Waldeyer Ring/chemoradiotherapy; Prognosis
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clinical disparity and favorable prognoses for patients with Waldeyer Ring extranodal nasal type nk t cell lymphoma and diffuse large b cell lymphoma
American Journal of Clinical Oncology, 2014Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Qingfeng Liu, Zhao-yang Wang, Hui Fang, Hua Ren, Bo ChenAbstract:Objectives: This study aimed to compare the clinical characteristics and prognosis of Waldeyer Ring extranodal nasal-type natural killer (NK)/T-cell lymphoma (WR-NKTCL) and Waldeyer Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods: Consecutive diagnoses of 122 WR-DLBCL and 44 WR-NKTCL patients, receiving mainly primary radiotherapy in early-stage WR-NKTCL and primary chemotherapy in early-stage WR-DLBCL, were reviewed. Results: WR-NKTCL occurred predominately in young males, as nasopharyngeal stage I disease with B-symptoms, extranodal dissemination, and involving adjacent structures. WR-DLBCL was mainly stage II tonsillar disease with regional lymph node involvement. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 74% and 67% in WR-DLBCL, respectively, and 68% (P=0.468) and 59% (P=0.303) in WR-NKTCL. In stages I and II disease, WR-DLBCL 5-year OS and PFS were 79% and 76% compared with 72% (P=0.273) and 62% (P=0.117) in WR-NKTCL. In stage I disease, WR-DLBCL 5-year OS and PFS were 81% and 81%, compared with 76% (P=0.394) and 63% (P=0.236) in WR-NKTCL. In addition, the prognostic factors and failure patterns in WR-DLBCL and WR-NKTCL differed substantially. Conclusions: These results indicate that remarkable clinical disparities exist between WR-DLBCL and WR-NKTCL; however, different treatment strategies for each can result in similarly favorable prognoses.
Jialing Luo - One of the best experts on this subject based on the ideXlab platform.
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Radiotherapy for nasal cavity and Waldeyer Ring natural killer/T-cell lymphoma: Analysis in 131 patients.
Journal of Clinical Oncology, 2013Co-Authors: Yuan Zhu, Luying Liu, Jialing LuoAbstract:8553 Background: Theaim of this study was to evaluate the efficacy and prognosis of chemotherapy and radiotherapy for patients with nasal cavity and Waldeyer Ring natural killer/T cell lymphoma. Methods: Records of 131 patients who received chemotherapy or radiotherapy or chemoradiotherapy at Zhejiang Cancer Hospital between 2000 and 2010, were retrospectively reviewed. Ninety-eight patients received chemoradiotherapy. Thirty patients received radiotherapy, and three patients received chemotherapy. All patients had pathology and immunohistochemistry diagnosis. According to the Ann Arbor Staging System, majority of patients were staged as IE stage (116/131). 14 patients presented with IIE stage, and 1 IIIE stage. Thirty-four patients had B symptoms. Results: 109 patients were with nasal cavity NK/T cell lymphoma, and 22 patients with Waldeyer Ring NK/T cell lymphoma. Complete response (CR) was achieved in 116 (89%) patients. The 5-year overall survival (OS) rate and disease-free survival (DFS) rate for all...
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radiotherapy for nasal cavity and Waldeyer Ring natural killer t cell lymphoma analysis in 131 patients
Journal of Clinical Oncology, 2013Co-Authors: Yuan Zhu, Luying Liu, Jialing LuoAbstract:8553 Background: Theaim of this study was to evaluate the efficacy and prognosis of chemotherapy and radiotherapy for patients with nasal cavity and Waldeyer Ring natural killer/T cell lymphoma. Methods: Records of 131 patients who received chemotherapy or radiotherapy or chemoradiotherapy at Zhejiang Cancer Hospital between 2000 and 2010, were retrospectively reviewed. Ninety-eight patients received chemoradiotherapy. Thirty patients received radiotherapy, and three patients received chemotherapy. All patients had pathology and immunohistochemistry diagnosis. According to the Ann Arbor Staging System, majority of patients were staged as IE stage (116/131). 14 patients presented with IIE stage, and 1 IIIE stage. Thirty-four patients had B symptoms. Results: 109 patients were with nasal cavity NK/T cell lymphoma, and 22 patients with Waldeyer Ring NK/T cell lymphoma. Complete response (CR) was achieved in 116 (89%) patients. The 5-year overall survival (OS) rate and disease-free survival (DFS) rate for all...
Yongwen Song - One of the best experts on this subject based on the ideXlab platform.
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dosimetric and clinical outcomes with intensity modulated radiation therapy after chemotherapy for patients with early stage diffuse large b cell lymphoma of Waldeyer Ring
International Journal of Radiation Oncology Biology Physics, 2016Co-Authors: Shu-lian Wang, Weihu Wang, Jing Jin, Yongwen Song, Yueping Liu, Hui Fang, Hua Ren, Bo Chen, Mei Dong, Yuan TangAbstract:Purpose To assess the dosimetric benefit, prognosis, and toxicity of intensity modulated radiation therapy (IMRT) for early-stage, diffuse large B-cell lymphoma of Waldeyer Ring (WR-DLBCL). Methods and Materials Sixty-one patients with early-stage WR-DLBCL who received chemotherapy followed by IMRT were retrospectively reviewed. Dosimetric parameters for the target volume and critical normal structures were evaluated, and survival was calculated. Linear regression analysis was used to assess the effect of the mean dose (D mean ) to the parotid glands on xerostomia. Results The median conformity index and homogeneity index of the planning target volume (PTV) were 0.83 and 0.90, respectively, demonstrating very good coverage of the target volume. The mean dose to the parotid glands was 24.9 Gy. The 5-year overall survival (OS), progression-free survival (PFS), and locoregional control (LRC) were 94.7%, 93.1%, and 98.3%, respectively. Early and late toxicities were mild, and no patient experienced late grade ≥3 toxicities. The D mean to the parotid glands had a linear correlation with late grade ≥2 xerostomia. Conclusions IMRT after chemotherapy can provide excellent dose conformity and achieve favorable survival and LRC with mild toxicities in patients with early-stage WR-DLBCL. Dose constraints for the parotid glands should be limited to
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Value of radiotherapy for early-stage Waldeyer’s Ring diffuse large B-cell lymphoma in the rituximab era
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the value of radiotherapy following rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based chemotherapy for patients with early-stage Waldeyer’s Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods Eighty-three patients diagnosed with early-stage WR-DLBCL who were admitted to our hospital from 2000 to 2013 were enrolled in the study. In these patients, twenty-five had stage Ⅰ disease and fifty-eight had stage Ⅱ disease. All patients received R-CHOP-based chemotherapy with (n=62) or without (n=21) involved-field radiotherapy (Waldeyer’s Ring plus cervical lymph nodes). The overall survival (OS), progression-free survival (PFS), and local-regional control (LRC) rates were calculated using the Kaplan-Meier method. The univariate analysis was performed using the log-rank method. The multivariate analysis was performed using the Cox regression model. Results In all patients, the 5-year sample size was 18; the 5-year OS, PFS, and LRC rates were 89%, 84%, and 90%, respectively. According to the univariate analysis, patient age greater than 60 years, an increased lactate dehydrogenase level, Eastern Cooperative Oncology Group (ECOG) performance status no less than 2, and International Prognostic Index (IPI) no less than 2 were poor prognostic factors. Patient age greater than 60 years, a tumor size no less than 5 cm, ECOG performance status no less than 2, and IPI no less than 2 were influencing factors for PFS and LRC rates. In addition to the treatment with rituximab, patients treated with consolidative radiotherapy had significantly higher PFS and LRC rates (94% vs. 58%, P=0.003; 100% vs. 61%, P=0.000) as well as slightly higher OS rate (94% vs. 71%, P=0.063) than those treated without radiotherapy. Conclusions Consolidative radiotherapy following R-CHOP-based chemotherapy significantly improves PFS, LRC, and probably OS rates for early-stage WR-DLBCL. This conclusion still needs to be confirmed by prospective studies with a large sample size. Key words: Waldeyer Ring diffuse large B-cell lymphoma/radiotherapy; Waldeyer Ring diffuse large B-cell lymphoma/chemotherapy; Rituximab
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value of radiotherapy for early stage Waldeyer s Ring diffuse large b cell lymphoma in the rituximab era
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the value of radiotherapy following rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based chemotherapy for patients with early-stage Waldeyer’s Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods Eighty-three patients diagnosed with early-stage WR-DLBCL who were admitted to our hospital from 2000 to 2013 were enrolled in the study. In these patients, twenty-five had stage Ⅰ disease and fifty-eight had stage Ⅱ disease. All patients received R-CHOP-based chemotherapy with (n=62) or without (n=21) involved-field radiotherapy (Waldeyer’s Ring plus cervical lymph nodes). The overall survival (OS), progression-free survival (PFS), and local-regional control (LRC) rates were calculated using the Kaplan-Meier method. The univariate analysis was performed using the log-rank method. The multivariate analysis was performed using the Cox regression model. Results In all patients, the 5-year sample size was 18; the 5-year OS, PFS, and LRC rates were 89%, 84%, and 90%, respectively. According to the univariate analysis, patient age greater than 60 years, an increased lactate dehydrogenase level, Eastern Cooperative Oncology Group (ECOG) performance status no less than 2, and International Prognostic Index (IPI) no less than 2 were poor prognostic factors. Patient age greater than 60 years, a tumor size no less than 5 cm, ECOG performance status no less than 2, and IPI no less than 2 were influencing factors for PFS and LRC rates. In addition to the treatment with rituximab, patients treated with consolidative radiotherapy had significantly higher PFS and LRC rates (94% vs. 58%, P=0.003; 100% vs. 61%, P=0.000) as well as slightly higher OS rate (94% vs. 71%, P=0.063) than those treated without radiotherapy. Conclusions Consolidative radiotherapy following R-CHOP-based chemotherapy significantly improves PFS, LRC, and probably OS rates for early-stage WR-DLBCL. This conclusion still needs to be confirmed by prospective studies with a large sample size. Key words: Waldeyer Ring diffuse large B-cell lymphoma/radiotherapy; Waldeyer Ring diffuse large B-cell lymphoma/chemotherapy; Rituximab
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clinical outcome and prognosis of Waldeyer s Ring diffuse large b cell lymphoma an analysis of 200 patients
Chinese Journal of Radiation Oncology, 2015Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Hui Fang, Hua Ren, Qingfeng LiuAbstract:Objective To evaluate the clinical features, treatment outcome, and prognostic factors in patients with primary Waldeyer' s Ring diffuse large B-cell lymphoma(WR-DLBCL). Methods This study included 200 patients with a confirmed diagnosis of primary WR-DLBCL admitted to our hospital from 2000 to 2013, who consisted of 50 stage I patients, 125 stage Ⅱ patients, and 25 stage Ⅲ-Ⅳ patients. Most patients received 4-6 cycles of CHOP or CHOP-based chemotherapy with or without involved field radiotherapy(Waldeyer's Ring+cervical lymph node region). Results The 5-year sample size was 71. The 5-year overall survival(OS), progression-free survival(PFS), and locoregional control(LRC)rates for the whole group were 78%, 72%, and 87%, respectively. In the 175 early stage patients, chemoradiotherapy resulted in significantly higher OS, PFS, and LRC than chemotherapy alone(86% vs. 70%, P= 0. 001 ; 84% vs. 58%, P= 0. 000; 97% vs. 66%,P=0. 000). Univariate analysis showed that age, tumor size, stage, lactate dehydrogenase leve, and International Prognostic Index were prognostic factors for OS, PFS, and LRC(P=0. 000-0. 036), while the prognostic factors for PFS also included Eastern Cooperative Oncology Group score and cervical nodal involvement(P = 0. 018). Multivariate analysis showed that age and stage were prognostic factors for OS and LRC(P=0. 003-0. 022), and age was the prognostic factor for PFS(P= 0. 000). Conclusions WR-DLBCL has distinct clinical features and favorable prognoses. For early stage patients, combined-modality therapy results in significantly higher OS, PFS, and LRC. Key words: Diffuse large B-cell lymphoma, Waldeyer Ring/chemoradiotherapy; Prognosis
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clinical disparity and favorable prognoses for patients with Waldeyer Ring extranodal nasal type nk t cell lymphoma and diffuse large b cell lymphoma
American Journal of Clinical Oncology, 2014Co-Authors: Weihu Wang, Jing Jin, Yongwen Song, Shu-lian Wang, Yueping Liu, Qingfeng Liu, Zhao-yang Wang, Hui Fang, Hua Ren, Bo ChenAbstract:Objectives: This study aimed to compare the clinical characteristics and prognosis of Waldeyer Ring extranodal nasal-type natural killer (NK)/T-cell lymphoma (WR-NKTCL) and Waldeyer Ring diffuse large B-cell lymphoma (WR-DLBCL). Methods: Consecutive diagnoses of 122 WR-DLBCL and 44 WR-NKTCL patients, receiving mainly primary radiotherapy in early-stage WR-NKTCL and primary chemotherapy in early-stage WR-DLBCL, were reviewed. Results: WR-NKTCL occurred predominately in young males, as nasopharyngeal stage I disease with B-symptoms, extranodal dissemination, and involving adjacent structures. WR-DLBCL was mainly stage II tonsillar disease with regional lymph node involvement. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 74% and 67% in WR-DLBCL, respectively, and 68% (P=0.468) and 59% (P=0.303) in WR-NKTCL. In stages I and II disease, WR-DLBCL 5-year OS and PFS were 79% and 76% compared with 72% (P=0.273) and 62% (P=0.117) in WR-NKTCL. In stage I disease, WR-DLBCL 5-year OS and PFS were 81% and 81%, compared with 76% (P=0.394) and 63% (P=0.236) in WR-NKTCL. In addition, the prognostic factors and failure patterns in WR-DLBCL and WR-NKTCL differed substantially. Conclusions: These results indicate that remarkable clinical disparities exist between WR-DLBCL and WR-NKTCL; however, different treatment strategies for each can result in similarly favorable prognoses.
