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Open Access 24-01-2025 | Radiotherapy | Research

The association between radiotherapy and the prognosis of follicular lymphoma patients with different characteristics in the rituximab era: a cohort study based on Surveillance, Epidemiology and End Results

Authors: Liyin Li, Zhenxin He, Qiang Zhou, Bo Nie

Published in: Annals of Hematology

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Abstract

This retrospective cohort study examined the association between radiotherapy and prognosis in follicular lymphoma (FL) patients, with stratification by age, Ann Arbor stage, primary tumor site, surgical status, and grade. Using data from the SEER database, we employed Cox proportional hazards and competing risk models to assess the impact of radiotherapy on overall survival (OS) and cancer-specific survival (CSS) in 7,551 FL patients. The association between radiotherapy and second primary cancer (SPC) was explored using Logistic regression model. At the end of the 60-month follow-up, 6,053 patients were alive, while 1,498 had died. The overall result showed that radiotherapy was associated with the better OS [hazard ratio (HR): 0.70, 95% confidence interval (95%CI): 0.59–0.83, P < 0.001] and CSS (HR: 0.67, 95% CI: 0.52–0.87, P = 0.002)) in FL patients. Radiotherapy was associated with improved OS and CSS in patients aged ≥ 60 years [OS: HR: 0.65, CI: 0.53–0.79; CSS: HR: 0.63, CI: 0.52–0.77], early Ann Arbor stage (OS HR: 0.51, CI: 0.40–0.65; CSS HR: 0.51, CI: 0.40–0.65), primary sites at lymph nodes (OS HR: 0.76, CI: 0.62–0.93; CSS HR: 0.76, CI: 0.62–0.93) and skin/soft tissue (OS HR: 0.35, CI: 0.16–0.81; CSS HR: 0.36, CI: 0.16–0.82), and in both surgical (OS HR: 0.70, CI: 0.52–0.93; CSS HR: 0.70, CI: 0.52–0.93) and non-surgical patients (OS HR: 0.71, CI: 0.56–0.89; CSS HR: 0.69, CI: 0.55–0.87). Radiotherapy showed no significant association with second primary cancer (SPC) risk. These findings suggest radiotherapy improves 5-year survival outcomes in FL patients during the rituximab era.
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Literature
5.
go back to reference Brady JL, Binkley MS, Hajj C, Chelius M, Chau K, Balogh A, Levis M, Filippi AR, Jones M, Mac Manus M, Wirth A, Oguchi M, Vistisen AK, Andraos TY, Ng AK, Aleman BMP, Choi SH, Kirova Y, Hardy S, Reinartz G, Eich HT, Bratman SV, Constine LS, Suh CO, Dabaja B, El-Galaly TC, Hodgson DC, Ricardi U, Yahalom J, Hoppe RT, Mikhaeel NG (2019) Definitive radiotherapy for localized follicular lymphoma staged by (18)F-FDG PET-CT: a collaborative study by ILROG. Blood 133(3):237–245. https://doi.org/10.1182/blood-2018-04-843540CrossRefPubMed Brady JL, Binkley MS, Hajj C, Chelius M, Chau K, Balogh A, Levis M, Filippi AR, Jones M, Mac Manus M, Wirth A, Oguchi M, Vistisen AK, Andraos TY, Ng AK, Aleman BMP, Choi SH, Kirova Y, Hardy S, Reinartz G, Eich HT, Bratman SV, Constine LS, Suh CO, Dabaja B, El-Galaly TC, Hodgson DC, Ricardi U, Yahalom J, Hoppe RT, Mikhaeel NG (2019) Definitive radiotherapy for localized follicular lymphoma staged by (18)F-FDG PET-CT: a collaborative study by ILROG. Blood 133(3):237–245. https://​doi.​org/​10.​1182/​blood-2018-04-843540CrossRefPubMed
6.
go back to reference Tobin JWD, Rule G, Colvin K, Calvente L, Hodgson D, Bell S, Dunduru C, Gallo J, Tsang ES, Tan X, Wong J, Pearce J, Campbell R, Tneh S, Shorten S, Ng M, Cochrane T, Tam CS, Abro E, Hawkes E, Hodges G, Kansara R, Talaulikar D, Gilbertson M, Johnston AM, Savage KJ, Villa D, Morris K, Ratnasingam S, Janowski W, Kridel R, Cheah CY, MacManus M, Matigian N, Mollee P, Gandhi MK, Hapgood G (2019) Outcomes of stage I/II follicular lymphoma in the PET era: an international study from the Australian Lymphoma Alliance. Blood Adv 3(19):2804–2811. https://doi.org/10.1182/bloodadvances.2019000458CrossRefPubMedPubMedCentral Tobin JWD, Rule G, Colvin K, Calvente L, Hodgson D, Bell S, Dunduru C, Gallo J, Tsang ES, Tan X, Wong J, Pearce J, Campbell R, Tneh S, Shorten S, Ng M, Cochrane T, Tam CS, Abro E, Hawkes E, Hodges G, Kansara R, Talaulikar D, Gilbertson M, Johnston AM, Savage KJ, Villa D, Morris K, Ratnasingam S, Janowski W, Kridel R, Cheah CY, MacManus M, Matigian N, Mollee P, Gandhi MK, Hapgood G (2019) Outcomes of stage I/II follicular lymphoma in the PET era: an international study from the Australian Lymphoma Alliance. Blood Adv 3(19):2804–2811. https://​doi.​org/​10.​1182/​bloodadvances.​2019000458CrossRefPubMedPubMedCentral
8.
go back to reference Lin Z, Zha J, Yi S, Li Z, Ping L, He X, Fan L, Yu H, Zheng Z, Xu W, Chen F, Xie Y, Chen B, Zhang H, Wang L, Ding K, Li W, Yang H, Zhao W, Qiu L, Li Z, Song Y, Xu B (2023) Clinical characteristics and outcomes of follicular lymphoma patients with extranodal involvement: analysis of a series of 1090 cases in China. Clin Translational Oncology: Official Publication Federation Span Oncol Soc Natl Cancer Inst Mexico 25(6):1821–1829. https://doi.org/10.1007/s12094-023-03081-0CrossRef Lin Z, Zha J, Yi S, Li Z, Ping L, He X, Fan L, Yu H, Zheng Z, Xu W, Chen F, Xie Y, Chen B, Zhang H, Wang L, Ding K, Li W, Yang H, Zhao W, Qiu L, Li Z, Song Y, Xu B (2023) Clinical characteristics and outcomes of follicular lymphoma patients with extranodal involvement: analysis of a series of 1090 cases in China. Clin Translational Oncology: Official Publication Federation Span Oncol Soc Natl Cancer Inst Mexico 25(6):1821–1829. https://​doi.​org/​10.​1007/​s12094-023-03081-0CrossRef
18.
go back to reference Zhong Q, Liu Y, Wu Y, Liu X, Chen S, Chen B, Su F, Li G, Xu Y, Liu L, Chen F, Qi S, Li Y (2023) Impact of age on long-term relative survival benefit of radiotherapy for early-stage grade I-II follicular lymphoma from the SEER database (2000–2015). Leuk Lymphoma 1–11. https://doi.org/10.1080/10428194.2023.2283296 Zhong Q, Liu Y, Wu Y, Liu X, Chen S, Chen B, Su F, Li G, Xu Y, Liu L, Chen F, Qi S, Li Y (2023) Impact of age on long-term relative survival benefit of radiotherapy for early-stage grade I-II follicular lymphoma from the SEER database (2000–2015). Leuk Lymphoma 1–11. https://​doi.​org/​10.​1080/​10428194.​2023.​2283296
26.
go back to reference Prusila REI, Sorigue M, Jauhiainen J, Mercadal S, Postila A, Salmi P, Tanhua T, Tikkanen S, Kakko S, Kuitunen H, Pollari M, Nystrand I, Kuusisto MEL, Vasala K, Jantunen E, Korkeila E, Karihtala P, Sancho JM, Turpeenniemi-Hujanen T, Kuittinen O (2019) Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the Rituximab era. Br J Haematol 187(3):364–371. https://doi.org/10.1111/bjh.16090CrossRefPubMed Prusila REI, Sorigue M, Jauhiainen J, Mercadal S, Postila A, Salmi P, Tanhua T, Tikkanen S, Kakko S, Kuitunen H, Pollari M, Nystrand I, Kuusisto MEL, Vasala K, Jantunen E, Korkeila E, Karihtala P, Sancho JM, Turpeenniemi-Hujanen T, Kuittinen O (2019) Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the Rituximab era. Br J Haematol 187(3):364–371. https://​doi.​org/​10.​1111/​bjh.​16090CrossRefPubMed
Metadata
Title
The association between radiotherapy and the prognosis of follicular lymphoma patients with different characteristics in the rituximab era: a cohort study based on Surveillance, Epidemiology and End Results
Authors
Liyin Li
Zhenxin He
Qiang Zhou
Bo Nie
Publication date
24-01-2025
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-025-06209-0

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