The Value Of Radiotherapy After Rituximab Immunochemotherapy In Early Stage Of Primary Waldeyer’s Ring Diffuse Large B-cell Lymphoma

Objective:To analyze the value of radiotherapy in the treatment of limited stage Waldeyer’s ring diffuse large B-cell lymphoma after chemotherapy combined with Rituximab.Method:93 patients with limited stage(Ⅰ-Ⅱ)primary waldeyer’s ring diffuse large B cell lymphoma from 2010 to 2017 were included.There were38 cases in pure chemotherapy group only treated with R-CHOP or R-CHOP-like chemotherapy,and 55 cases accepted the chemotherapy with consolidation radiotherapy called comprehensive treatment group.Kaplan-Meier method was used to calculate PFS,OS and LRC,and performed to univariate analysis.Log-rank method was used to test the survival difference between the two groups.and Cox multivariate regression analysis was performed in the study.Results:The median follow-up period was 47 months,with a sample size of 67 cases at 3 years.The 3-year PFS,3-year OS and 3-year LRC of the chemotherapy alone group and combined treatment group were 76.1% vs94.2%(P=0.036),78.6% vs 96.0%(P=0.032),and 83.1% vs 98.1%(P=0.015),respectively.The PFS,OS and LRC of 62 patients who reached CR after chemotherapy were 97.6% vs 87.8%(P=0.164),97.4% vs 93.8%(P=0.522)and 100.0% vs 87.8%(P=0.028)in the combined treatment group and chemotherapy alone group,respectively.Univariate prognostic analysis showed that age > 60 years old、chemotherapy efficacy below CR(non-CR)and without radiotherapy were adverse prognostic factors for PFS and OS,while B symptoms、non-CR and without radiotherapy were adverse prognostic factors for LRC.Multivariate prognostic analysis showed that non-CR was a poor prognostic factor for PFS and OS,and B-symptoms,non-CR and without radiotherapy were poor prognostic factors for LRC.Conclusion:Radiotherapy following CHOP chemotherapy combination with rituximab improved PFS,OS and LRC of patients with stage Ⅰ-Ⅱ primary waldeyer’s ring diffuse large B-cell lymphoma.